RESUMO
The blue iguana (Cyclura lewisi) is an endangered rock iguana species native to Grand Cayman, in the Cayman Islands. Health assessments were conducted on captive and free-roaming iguanas in 2001 and 2003-2014 and were performed in the summer wet season (June-July) of 2003-2004 and 2010-2014 and in the winter dry season (November-December) of 2001 and 2005-2009. Morphometric data were recorded from iguanas when blood samples were collected: 903 samples were collected and data from 890 samples from 775 iguanas were included. Samples were analyzed for hematology, plasma biochemistry, protein electrophoresis, mineral panels, 25-hydroxyvitamin D, and testosterone. Reference intervals were created for captive subadults, captive adults, and free-roaming adults when data were sufficient. Significant differences among these groups were described, as were differences on the basis of sex, season, and origin (captive vs free-roaming). In captive iguanas, most analytes were significantly different between subadults and adults, mature heterophils and copper were significantly higher in the dry season, zinc levels were significantly higher in the wet season, and cholesterol and triglycerides were significantly higher in adult females than adult males. Testosterone in adult males was significantly higher in the dry season. These results will aid in future health assessments and disease investigations in wild and captive populations of blue iguanas and are of comparative value for other Cyclura species that are free-roaming, captive, and, especially, in similar conservation release programs.
Assuntos
Proteínas Sanguíneas/química , Eletroforese/veterinária , Contagem de Eritrócitos/veterinária , Hematócrito/veterinária , Iguanas/sangue , Contagem de Leucócitos/veterinária , Amilases/sangue , Animais , Aspartato Aminotransferases/sangue , Glicemia , Nitrogênio da Ureia Sanguínea , Cloretos/sangue , Colesterol/sangue , Creatina Quinase/sangue , Creatinina/sangue , Eletrólitos/sangue , L-Lactato Desidrogenase/sangue , Minerais/sangue , Valores de Referência , Índias OcidentaisRESUMO
Human genomes are typically assembled as consensus sequences that lack information on parental haplotypes. Here we describe a reference-free workflow for diploid de novo genome assembly that combines the chromosome-wide phasing and scaffolding capabilities of single-cell strand sequencing1,2 with continuous long-read or high-fidelity3 sequencing data. Employing this strategy, we produced a completely phased de novo genome assembly for each haplotype of an individual of Puerto Rican descent (HG00733) in the absence of parental data. The assemblies are accurate (quality value > 40) and highly contiguous (contig N50 > 23 Mbp) with low switch error rates (0.17%), providing fully phased single-nucleotide variants, indels and structural variants. A comparison of Oxford Nanopore Technologies and Pacific Biosciences phased assemblies identified 154 regions that are preferential sites of contig breaks, irrespective of sequencing technology or phasing algorithms.
Assuntos
Genoma Humano , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Pais , Análise de Sequência de DNA/métodos , Análise de Célula Única/métodos , Algoritmos , Haplótipos , Humanos , Porto Rico/etnologiaRESUMO
Conservation strategies for crocodilians often include captive breeding to create stable assurance populations. Evaluating adrenal and gonadal hormone patterns can provide animal managers with data to more effectively monitor animal welfare and reproductive status. This study evaluated the effects of season (breeding, nesting, or off), sex (male and female), and reproductive status of females (egg-laying/housed with a male or non-laying/housed solo) on concentrations of fecal glucocorticoid metabolite (FGM), fecal androgen metabolite (FAM), and fecal progestogen metabolite (FPM) in seven Cuban crocodiles, Crocodylus rhombifer, at the Smithsonian's National Zoological Park. Overall, seasonal changes in FGM and FPM concentrations were only observed in egg-laying females; FGM and FPM concentrations were both higher during the nesting season compared to the breeding and off seasons. Seasonal changes in FAM concentrations were only observed in males; males had higher FAM concentrations during the breeding and nesting seasons compared to the off season. Future studies investigating the use of fecal hormone metabolites in crocodilians are necessary to understand differences between individuals and species, to further elucidate the interactions between hormones and environmental factors, such as social housing, and to develop long-term datasets for the management of this species.
Assuntos
Córtex Suprarrenal/metabolismo , Jacarés e Crocodilos/fisiologia , Androgênios/metabolismo , Fezes/química , Glucocorticoides/metabolismo , Reprodução/fisiologia , Córtex Suprarrenal/fisiologia , Androgênios/química , Animais , Animais de Zoológico , Feminino , Glucocorticoides/química , Masculino , Estações do AnoRESUMO
INTRODUCTION: Morbidity and mortality rates among Dominican children are a serious health concern worsened by a lack of preventive care that hinders early identification and avoidance of illnesses. The purpose of this study was to improve health outcomes in Dominican children by implementing a well-child examination (WCE) protocol entitled "Watch Me Grow." METHODS: A quantitative, descriptive methodology was used. Twelve adults involved in pediatric care with the Foundation for Peace organization in the Dominican Republic were designated to receive WCE protocol education, and 159 children received WCEs and health promotion teaching. RESULTS: No statistically significant improvement in WCE knowledge was noted. The most common abnormal findings were unhealthy weight (47.8%), dental caries (46.5%), low vision (17.0%), and elevated blood pressure (15.7%). DISCUSSION: The WCE protocol facilitated early identification of many pediatric health concerns and may help diminish the potential future impact of illnesses on Dominican children.
Assuntos
Serviços de Saúde da Criança/organização & administração , Atenção à Saúde/organização & administração , Promoção da Saúde/organização & administração , Prevenção Primária/organização & administração , Criança , Pré-Escolar , Aconselhamento , República Dominicana/epidemiologia , Estudos de Avaliação como Assunto , Feminino , Humanos , Lactente , Masculino , Pediatria , Serviços de Saúde Escolar/organização & administraçãoRESUMO
Little is known about current attitudes towards cousin marriages. Using data from a rural population in the Mexican state of Oaxaca, the present research examined how life history was related to attitudes towards cousin marriages in various ethnic groups. Participants were 205 parents from three ethnic groups. i.e., Mestizos (people of mixed descent, n = 103), indigenous Mixtecs (n = 65), and Blacks (n = 35). Nearly all men in this study were farm workers or fishermen. Participants reported more negative than positive attitudes towards cousin marriage, and women reported more negative attitudes than did men. The main objection against marrying a cousin was that it is wrong for religious reasons, whereas the risk of genetic defects was considered relatively unimportant. Cousin marriage was not considered to contribute to the quality and unity of marriage and the family. The three ethnic groups did not differ in their attitude towards cousin marriages. However, a slower life history was related to a more negative attitude towards cousin marriages, especially among Blacks, less so among Mixtecs, and not at all among Mestizos. In addition, and independent of the effect of life history, with increasing levels of parental control over mate choice, the attitude towards cousin marriage was more positive, but among men the attitude was more negative the more religious they were. The results are discussed in the context of theorizing on life history theory and the benefits and costs of cousin marriages.
Assuntos
Atitude/etnologia , Comportamento de Escolha , Consanguinidade , Etnicidade/psicologia , Casamento/etnologia , Adolescente , Adulto , População Negra , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Modelos Lineares , Masculino , Casamento/psicologia , México , Relações Pais-Filho/etnologia , Pais/psicologia , Psicometria , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Injuries in Jamaica are a major public health problem as demonstrated by a hospital based computerized injury surveillance system established in 1999 that provides a risk profile for injuries. SUBJECTS AND METHOD: Injury data from 2004 were selected to provide an annual profile, as comprehensive injury data were available from nine public hospitals. These nine public hospitals provide care for 70% of the Jamaicans admitted to hospitals annually. RESULTS: Data are presented on unintentional injuries where falls caused 44%, lacerations 27% and accidental blunt injuries were 17% of these. For motor vehicle related injuries, 55% were sustained while commuting by motorcars, 17% while riding motorbikes/bicycles and 16% of those injured were pedestrians. Most violence related injuries were due to fights (76%) with acquaintances (47%) who used sharp objects (40%) to inflict the injury. CONCLUSION: The Jamaica Injury Surveillance System (JISS) data, augmented by data collected on injuries from the health centres and the sentinel surveillance system, give a measure of the magnitude of the impact of injuries on the health services. The JISS provides data on the profile of injuries seen and treated at health facilities in Jamaica. In collaboration with police data and community-based surveys, it can be used to complete the risk profiles for different types of injuries. The data generated at the parish, regional and national levels form the basis for the design and monitoring of prevention programmes, as well as serve to support and evaluate policy, legislative control measures and measures that impact on interventions.
Assuntos
Vigilância da População , Ferimentos e Lesões/epidemiologia , Coleta de Dados , Feminino , Controle de Formulários e Registros , Sistemas de Informação Hospitalar , Hospitais Públicos , Humanos , Jamaica/epidemiologia , Masculino , Sistema de Registros , Fatores de RiscoRESUMO
Understanding successional trends in energy and matter exchange across the ecosystem-atmosphere boundary layer is an essential focus in ecological research; however, a general theory describing the observed pattern remains elusive. This paper examines whether the principle of maximum entropy production could provide the solution. A general framework is developed for calculating entropy production using data from terrestrial eddy covariance and micrometeorological studies. We apply this framework to data from eight tropical forest and pasture flux sites in the Amazon Basin and show that forest sites had consistently higher entropy production rates than pasture sites (0.461 versus 0.422 W m(-2) K(-1), respectively). It is suggested that during development, changes in canopy structure minimize surface albedo, and development of deeper root systems optimizes access to soil water and thus potential transpiration, resulting in lower surface temperatures and increased entropy production. We discuss our results in the context of a theoretical model of entropy production versus ecosystem developmental stage. We conclude that, although further work is required, entropy production could potentially provide a much-needed theoretical basis for understanding the effects of deforestation and land-use change on the land-surface energy balance.
Assuntos
Conservação dos Recursos Naturais/tendências , Ecossistema , Entropia , Modelos Teóricos , Rios , Brasil , Meteorologia , Transpiração Vegetal , Radiação , Solo , Temperatura , Árvores , Movimentos da ÁguaRESUMO
The Jamaica Perinatal Morbidity and Mortality Survey (JPMMS) was a national study designed to identify modifiable risk factors associated with poor maternal and perinatal outcome. Needing to better understand factors that promote or retard child development, behaviour and academic achievement, we conducted follow-up studies of the birth cohort. The paper describes the policy developments from the JPMMS and two follow-up rounds. The initial study (1986-87) documented 94% of all births and their outcomes on the island over 2 months (n = 10 508), and perinatal (n = 2175) and maternal deaths (n = 62) for a further 10 months. A subset of the birth cohort, identified by their date of birth through school records, was seen at ages 11-12 (n = 1715) and 15-16 years (n = 1563). Findings from the initial survey led to, inter alia, clinic-based screening for syphilis, referral high-risk clinics run by visiting obstetricians, and the redesign and construction of new labour wards at referral hospitals. The follow-up studies documented inadequate academic achievement among boys and children attending public schools, and associations between under- and over-nutrition, excessive television viewing (>20 h/week), inadequate parental supervision and behavioural problems. These contributed to the development of a television programming code for children, a National Parenting Policy, policies aimed at improving inter-sectoral services to children from birth to 5 years (Early Childhood Commission) and behavioural interventions of the Violence Prevention Alliance (an inter-sectoral NGO) and the Healthy Lifestyles project (Ministry of Health). Indigenous maternal and child health research provided a local evidence base that informed public policy. Collaboration, good communication, being vigilant to opportunities to influence policy, and patience has contributed to our success.
Assuntos
Serviços de Saúde Comunitária/normas , Atenção à Saúde/normas , Política de Saúde , Mortalidade Materna , Mortalidade Perinatal , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Serviços de Saúde do Adolescente/normas , Adulto , Criança , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde da Criança/normas , Pré-Escolar , Estudos de Coortes , Serviços de Saúde Comunitária/organização & administração , Atenção à Saúde/organização & administração , Escolaridade , Feminino , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Jamaica , Estilo de Vida , Masculino , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/normas , Avaliação de Processos e Resultados em Cuidados de Saúde , Poder Familiar , Formulação de Políticas , Gravidez , Fatores de Risco , Televisão/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To compare perinatal and social factors in students admitted to The University of the West Indies (UWI), Kingston, Jamaica, at age 18 years with those in the rest of the Jamaican Perinatal Cohort. METHOD: The Jamaican Perinatal Survey recorded demographic and perinatal details in 10 527 or 97% of births in Jamaica in September and October 1986. Eighteen years later 140 of these were admitted to the UWI in Kingston, Jamaica. The perinatal features of these UWI students have been compared with the rest of the Perinatal Survey Cohort. RESULTS: Mothers of UWI students were older (p < 0.001), more likely to be married at the time of birth (p < 0.001), had earlier and more complete antenatal care (p < 0.05) and greater educational achievement at time of pregnancy (p < 0.001). These mothers of UWI students were also more likely to have diabetes (p < 0.01), operative deliveries (p < 0.01) and to attend private hospitals (p < 0.01). The UWI students had fewer siblings by their mothers (p < 0.05), were less likely to be low birthweight babies (p = 0.035) and more likely to be full-term (37-42 weeks) than lower gestational age (p = 0.005). Differences in Apgar scores did not reach statistical significance. CONCLUSIONS: The students of the University of the West Indies were more likely to come from smaller families with features indicative of a better quality of life. They were also of higher birthweight and tended to be full-term. The lack of association of Apgar scores with educational attainment is noteworthy.
Assuntos
Escolaridade , Estudantes/estatística & dados numéricos , Adulto , Índice de Apgar , Peso ao Nascer , Estudos de Coortes , Feminino , Humanos , Jamaica , Gravidez , Fatores Socioeconômicos , Universidades , Adulto JovemRESUMO
The purpose of this survey is to determine health-seeking behaviour, nutritional status and lifestyles of adolescents aged 10-15 years. A random sample of 3003 (1 422 males and 1 581 females) school-children, aged 10-15 years, was studied in a cross-sectional, interviewer-administered school-based survey conducted in all school types islandwide in a nationally representative sample of Jamaican children currently attending school. Some 3003 youths, 1422 males and 1581 females were interviewed. Males and females had similar healthcare-seeking behaviour but fewer students attending schools in rural areas reported having their eyes or hearing checked, or had seen a dentist than those attending urban schools. Some twelve per cent of adolescents were overweight/ obese. More females than males and more urban than rural students were overweight or obese. More boys (86.3%) were physically active in the last week than girls (75%). Physical activity peaked at age 13 years and was lowest at ages 11 and 14-15 years. Some 13% of adolescents 10-15 years old reported having had sexual intercourse, with boys being four times as likely as girls to report sexual activity (OR- 4.97; C.I. - 3.82, 6.47). The median age of sexual debut was 15.43 years for boys and over 15 years for girls. One-third of adolescents drank alcohol and 3% smoked marijuana in the past year. More boys than girls used drugs (p < 0.01). Some 14% of adolescents felt lonely, sad or wanted to cry most of the time/always. One-tenth seriously considered suicide. This study concluded that most adolescents attending primary and secondary schools in Jamaica were not involved in risky behaviour. However, it reveals some critical areas of concern with regard to nutritional status and physical activity, emotional well-being, drug use and sexual activity.
El propósito de este estudio es determinar el comportamiento de búsqueda de la salud, el nivel nutricional, y los estilos de vida de adolescentes de 10-15 años. Una muestra aleatoria de 3003 (1422 varones y 1581 hembras) escolares de 10-15 años de edad, fue sometida a una encuesta transversal aplicada por el entrevistador. La encuesta con sede en la escuela, fue conducida en todos los tipos de escuela a lo largo de la isla en una muestra nacionalmente representativa de niños y niñas jamaicanos que asisten a la escuela actualmente. Se entrevistaron unos 3003 jóvenes, 1422 varones y 1581 hembras. Los varones y las hembras tenían comportamientos de búsqueda de la salud similares pero el número de estudiantes que reportó haber tenido chequeos de la vista o de la audición, o haber visto a un dentista, fue menor entre aquellos que asistían a las escuelas en áreas rurales que entre los que asistían a escuelas urbanas. Alrededor del doce por ciento de los adolescentes eran obesos o estaban pasados de peso. Más hembras que varones y más estudiantes urbanos que rurales estaba pasados de peso o eran obesos. Más muchachos (86.3%) que muchachas (75%) estaban físicamente activos en la última semana. La actividad física alcanzó su punto máximo en la edad 13 años y el más bajo en las edades 11 y 14-15 años. Alrededor de 13% de adolescentes de 10-15 años reportaron haber tenido relaciones sexuales, siendo el caso que la tendencia a reportar actividad sexual fue cuatro veces mayor en los muchachos que en las muchachas (OR- 4.97; C.I. - 3.82, 6.47). La edad promedio de la iniciación sexual fue de 15.43 años para los muchachos y mayor de 15 años para las muchachas. Un tercio de los adolescentes bebió alcohol y un 3% fumó marihuana el año pasado. Más muchachos que las muchachas consumían drogas (p < 0.01). Alrededor del 14% de los adolescentes se sentían solos, tristes o sentían deseos de llorar la mayor parte del tiempo/siempre. La décima parte de ellos consideró seriamente la posibilidad de suicidio. Este estudio concluyó que la mayoría de los adolescentes que asisten a las escuelas primarias y secundarias en Jamaica no estuvieron involucrados en conductas de riesgo. Sin embargo, se ponen de manifiesto algunas áreas críticas de preocupación con respecto al nivel nutricional y la actividad física, el bienestar emocional, el uso de drogas y la actividad sexual.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Comportamento do Adolescente , Comportamentos Relacionados com a Saúde , Distribuição por Idade , Jamaica/epidemiologia , Saúde Mental/estatística & dados numéricos , Inquéritos Nutricionais , Sobrepeso/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Distribuição por Sexo , Comportamento Sexual/estatística & dados numéricosRESUMO
The purpose of this survey is to determine health-seeking behaviour, nutritional status and lifestyles of adolescents aged 10-15 years. A random sample of 3003 (1422 males and 1581 females) schoolchildren, aged 10-15 years, was studied in a cross-sectional, interviewer-administered school-based survey conducted in all school types islandwide in a nationally representative sample of Jamaican children currently attending school. Some 3003 youths, 1422 males and 1581 females were interviewed. Males and females had similar healthcare-seeking behaviour but fewer students attending schools in rural areas reported having their eyes or hearing checked, or had seen a dentist than those attending urban schools. Some twelve per cent of adolescents were overweight/obese. More females than males and more urban than rural students were overweight or obese. More boys (86.3%) were physically active in the last week than girls (75%). Physical activity peaked at age 13 years and was lowest at ages 11 and 14-15 years. Some 13% of adolescents 10-15 years old reported having had sexual intercourse, with boys being four times as likely as girls to report sexual activity (OR - 4.97; C.I. - 3.82, 6.47). The median age of sexual debut was 15.43 years for boys and over 15 years for girls. One-third of adolescents drank alcohol and 3% smoked marijuana in the past year. More boys than girls used drugs (p < 0.01). Some 14% of adolescents felt lonely, sad or wanted to cry most of the time/always. One-tenth seriously considered suicide. This study concluded that most adolescents attending primary and secondary schools in Jamaica were not involved in risky behaviour. However, it reveals some critical areas of concern with regard to nutritional status and physical activity, emotional well-being, drug use and sexual activity.
Assuntos
Comportamento do Adolescente , Comportamentos Relacionados com a Saúde , Adolescente , Distribuição por Idade , Criança , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Saúde Mental/estatística & dados numéricos , Inquéritos Nutricionais , Sobrepeso/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Distribuição por Sexo , Comportamento Sexual/estatística & dados numéricosRESUMO
Research into selected health problems across the life cycle are discussed with respect to the application and impact of the findings on policy, programme development and health outcomes. Special emphasis is placed on health research that focussed on the perinatal period, the young child and adolescent, the epidemics of chronic diseases and violence and the linkage between health and tourism. The lessons learnt over more than two decades of practice in the field of public health from conducting research aimed at developing an indigenous evidence base for policies and programmes in Jamaica are summarized.
Assuntos
Política de Saúde , Saúde Pública , Criança , Desenvolvimento Infantil , Proteção da Criança , Doença Crônica , Pesquisa sobre Serviços de Saúde , Humanos , Jamaica , Serviços de Saúde Materna , Bem-Estar Materno , Pesquisa , ViolênciaRESUMO
OBJECTIVES: To assess factors associated with under-reporting of maternal deaths from 1998, when maternal deaths became a Class I notifiable event in Jamaica and continuous maternal mortality surveillance was introduced, through 2003. METHODS: The number of deaths notified was compared with the number of independently identified deaths for each period and region studied, and key informants reported on their experience of the surveillance process. RESULTS: By 2000, approximately 80% of maternal deaths were reported, and was more consistent in 2 of the 4 regions. In these 2 regions someone was responsible for active surveillance and there was an established maternal mortality committee to review cases. Factors associated with nonreporting were no postmortem examination, death in the first trimester of pregnancy, and time interval between pregnancy termination and death. The surveillance staff requested guidelines on monitoring interregional transfers and technical assistance in developing action plans. CONCLUSION: Active hospital surveillance must include all wards, including the emergency department. Community surveillance should include forensic pathologists. National leadership is needed to summarize trends, address policy, and provide technical assistance to the surveillance staff.
Assuntos
Mortalidade Materna/tendências , Vigilância da População , Adolescente , Adulto , Países em Desenvolvimento , Feminino , Humanos , Jamaica/epidemiologia , Pessoa de Meia-Idade , GravidezRESUMO
The aim of this study was to provide standards for the assessment of birthweight, head circumference and crown-heel length for normal, singleton newborns of predominantly West African descent. Data were collected for 10 482 or 94of all recorded births in Jamaica during the two-month period September 1 to October 31, 1986. After editing procedures, data were available for 6178 (birthweight), 5975 (head circumference), and 5990 (crown-heel length). The data presented in tables and growth curves include birthweight, head circumference and crown-heel length for males and females separately, for gestational ages 30-43 weeks. Data sets from the University Hospital of the West Indies in 1990 and 1999 were used to explore the possibility of secular change over the period 1986-1999. In conclusion, these ethnic and gender-specific growth curves are based on the most extensive dataset currently available in Jamaica for babies of West African descent.
Assuntos
Humanos , Masculino , Feminino , Lactente , Antropometria , Cabeça/anatomia & histologia , Crescimento , Peso ao Nascer , Estudos Transversais , Jamaica , Recém-NascidoRESUMO
The aim of this study was to provide standards for the assessment of birthweight, head circumference and crown-heel length for normal, singleton newborns of predominantly West African descent. Data were collected for 10 482 or 94% of all recorded births in Jamaica during the two-month period September 1 to October 31, 1986. After editing procedures, data were available for 6178 (birthweight), 5975 (head circumference), and 5990 (crown-heel length). The data presented in tables and growth curves include birthweight, head circumference and crown-heel length for males and females separately, for gestational ages 30-43 weeks. Data sets from the University Hospital of the West Indies in 1990 and 1999 were used to explore the possibility of secular change over the period 1986-1999. In conclusion, these ethnic and gender-specific growth curves are based on the most extensive dataset currently available in Jamaica for babies of West African descent.
Assuntos
Antropometria , Peso ao Nascer , Crescimento , Cabeça/anatomia & histologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Jamaica , MasculinoRESUMO
Exposure to violence in childhood is associated with aggression in adulthood. The high level of community violence in Jamaica is likely to expose Jamaican children to violence. There has been no detailed study of the exposure of Jamaican children to violence in their daily lives. Some 1674 urban 11-12-year-old children, previously part of a national birth cohort study, completed a questionnaire detailing their exposure to violence as witnesses, victims and aggressors. Their parents completed a socio-economic questionnaire. Jamaican children had high levels of exposure to physical violence. A quarter of the children had witnessed severe acts of physical violence such as robbery, shooting and gang wars, a fifth had been victims of serious threats or robbery and one in every twelve had been stabbed. Children reported being least exposed to sexual violence and to being shot at. Robbery was an almost universal experience affecting children from all schools and socio-economic groups. The single commonest experience as a victim of violence was the loss of a family member or close friend to murder, affecting 36.8% of children. Children's experiences of witnessing violence occurred chiefly in their communities but their personal experiences of violence occurred at school. Boys and children attending primary school had greater exposure to violence as witnesses and victims. Socio-economic status discriminated exposure to physical violence as witnesses but not as victims. Intervention strategies to reduce children's exposure to violence should include community education on the impact of exposure to violence on children, particularly the loss of a significant person, and the development of a range of school-based violence prevention programmes.
Assuntos
Desenvolvimento Infantil , População Urbana , Violência , Agressão , Criança , Vítimas de Crime , Feminino , Humanos , Jamaica , Masculino , Análise Multivariada , Instituições Acadêmicas , Fatores SocioeconômicosRESUMO
The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6%) than women (4.3%) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0%) or a breast examination (31.2%). Current cigarette smoking was reported in 28.6% of men and 7.7% of women (OR 3.73 CI 2.71, 5.15), while 49.0% of men and 15.0% of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0%) than women (11.7%) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours.
Assuntos
Comportamentos Relacionados com a Saúde , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Jamaica/epidemiologia , Estilo de Vida , Masculino , Fumar Maconha/epidemiologia , Pessoa de Meia-Idade , Assunção de Riscos , Infecções Sexualmente Transmissíveis/epidemiologia , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
The purpose of this study was to assess the prevalence of high risk health behaviours among adult Jamaicans aged 15-49 years in 2000, and to compare the results with the 1993 survey. A nationally representative sample of 2013 persons aged 15-74 years was surveyed in 2000 using cluster sampling in the Jamaica Healthy Lifestyle Survey (Wilks et al, unpublished). Interviewer administered questionnaires and anthropometrical measurements were done. Data for a sub-sample of adults aged 15-49 years were analyzed The sub-sample included 1401 persons (473 men and 928 women). Significantly more men (18.6) than women (4.3) reported never having had a blood pressure check (p = 0.0001). Approximately one-third of the women reported that they had never had a Pap smear (36.0) or a breast examination (31.2). Current cigarette smoking was reported in 28.6 of men and 7.7 of women (OR 3.73 CI 2.71, 5.15), while 49.0 of men and 15.0 of women ever smoked marijuana (OR 3.28 CI 2.56, 4.20). Significantly more men (28.0) than women (11.7) reported ever having a sexually transmitted disease (OR 2.93 CI 2.16, 3.97); having more than one sexual partner in the past year (49.1 vs 11.4, OR 4.31 CI 3.22, 5.76) and usually using a condom during sexual intercourse (55.3 vs 40.5, OR 1.3 CI 1.11, 1.68). Between 1993 and 2000, significant trends include: more persons reported having a blood pressure check, a reduction in multiple sexual partners, increased condom use at last sex (women), reduced crack/cocaine use (males) and increased marijuana smoking. Although there were some significant positive lifestyle trends between 1993 and 2000, high risk behaviours remain common among Jamaican adults. Comprehensive health promotion programmes are needed to address these risk behaviours
El propósito de este estudio fue evaluar la prevalencia de conductas de alto riesgo para la salud entre adultos jamaicanos comprendidos en las edades de 15 a 49 en el año 2000, y comparar los resultados con la investigación realizada en 1993. Una muestra nacional representativa de 2013 personas comprendidas en las edades de 15 a 74 años, fue sometida a investigación en el 2000, usando el muestreo por cluster del Jamaica Healthy Lifestyle Survey (Wilks et al, inédito). Se realizaron entrevistas en forma de cuestionarios, así como mediciones antropométricas. Se analizaron los datos de una sub-muestra de adultos entre edades de 15 a 49 años. La submuestra incluyó 1401 personas (473 hombres y 928 mujeres). Un número de hombres significativamente mayor (18.6%) que el de las mujeres (4.3%) reportaron no haber tenido nunca un chequeo de la presión (p = 0.0001). Aproximadamente un tercio de las mujeres reportó no haberse hecho nunca la prueba citológica (36.0%) o el examen de mamas (31.2%). El hábito actual de fumar cigarrillos fue reportado en el 28.6% de los hombres y el 7.7% de las mujeres (OR 3.73 CI 2.71, 5.15), mientras que el 49.0% de los hombres y el 15% de las mujeres nunca fumó marihuana (OR 3.28 CI 2.56, 4.20). Significativamente más hombres (28.0%) que mujeres (11.7%) reportaron no haber tenido nunca enfermedades de transmisión sexual (OR 2.93 CI 2.16, 3.97); haber tenido más de una pareja sexual en el año anterior (49.1% vs 11.4%, OR 4.31 CI 3.22, 5.76), y usar comúnmente condón durante el acto sexual (55.3% vs 40.5%, OR 1.3 CI 1.11, 1.68). Entre 1993 y 2000, las tendencias significativas incluyen lo siguiente: más personas reportaron el chequeo de la presión sanguínea, una reducción en las parejas sexuales múltiples, el aumento del uso de condones en el último acto sexual (mujeres), la reducción en el uso de crack/cocaína (hombres), y aumento en el consumo de marihuana para fumar. Aunque hubo algunas tendencias positivas significativas en cuanto al estilo de vida entre 1993 y el 2000, los comportamientos de alto riesgo siguieron siendo comunes entre los adultos jamaicanos. Se necesitan programas generales de la promoción de la salud para abordar estas conductas de alto riesgo.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Comportamentos Relacionados com a Saúde , Assunção de Riscos , Consumo de Bebidas Alcoólicas/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia , Estilo de Vida , Fumar Maconha/epidemiologia , Jamaica/epidemiologia , Inquéritos Epidemiológicos , Tabagismo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
Exposure to violence in childhood is associated with aggression in adulthood. The high level of community violence in Jamaica is likely to expose Jamaican children to violence. There has been no detailed study of the exposure of Jamaican children to violence in their daily lives. Some 1674 urban 11-12-year-old children, previously part of a national birth cohort study, completed a questionnaire detailing their exposure to violence as witnesses, victims and aggressors. Their parents completed a socio-economic questionnaire. Jamaican children had high levels of exposure to physical violence. A quarter of the children had witnessed severe acts of physical violence such as robbery, shooting and gang wars, a fifth had been victims of serious threats or robbery and one in every twelve had been stabbed. Children reported being least exposed to sexual violence and to being shot at. Robbery was an almost universal experience affecting children from all schools and socio-economic groups. The single commonest experience as a victim of violence was the loss of a family member or close friend to murder, affecting 36.8 of children. Children's experiences of witnessing violence occurred chiefly in their communities but their personal experiences of violence occurred at school. Boys and children attending primary school had greater exposure to violence as witnesses and victims. Socio-economic status discriminated exposure to physical violence as witnesses but not as victims. Intervention strategies to reduce children's exposure to violence should include community education on the impact of exposure to violence on children, particularly the loss of a significant person, and the development of a range of school-based violence prevention programmes
La exposición a la violencia en la niñez se halla asociada con la agresión en la edad adulta. El alto nivel de violencia comunitaria en Jamaica, tiende a exponer a los niños jamaicanos a la violencia. Hasta el momento no ha habido un estudio detallado de la exposición de los niños jamaicanos a la violencia en sus vidas diarias. Unos 1 674 niños urbanos de 11 a 12 años de edad, quienes previamente formaban parte de un estudio de cohorte de nacimientos a escala nacional, respondieron a una encuesta dando detalles de su exposición a la violencia como testigos, víctimas y agresores. Sus padres respondieron una encuesta socioeconómica. Los niños jamaicanos presentaban altos niveles de exposición a la violencia física. Una cuarta parte de los niños había sido testigo de serios actos de violencia física, tales como robo con fuerza, tiroteos y guerras entre pandillas rivales. Una quinta parte de ellos había sido víctima de serias amenazas o de robo, y uno de cada doce había sido apuñalado. Los niños informaron haber estado menos expuestos a la violencia sexual y a los disparos. El robo fue casi una experiencia universal que afectó a los niños de todas las escuelas y grupos socio-económicos. La experiencia más común en cuanto a ser víctimas de la violencia estuvo dada por la pérdida de algún miembro de la familia o algún amigo cercano por asesinado, lo cual afectó al 36.8% de los niños. Las experiencias de los niños en relación con haber sido testigos de hechos violentos, tuvieron lugar principalmente en sus comunidades, pero sus experiencias personales de violencia ocurrieron en la escuela. Los niños que asistían a la escuela primaria estuvieron más expuestos a la violencia como testigos y como víctimas. El estatus socio-económico resultó un criterio discriminante en cuanto a la exposición a la violencia física en forma de testigo, pero no como la víctima. Las estrategias de intervención para reducir este problema deben incluir la educación de la comunidad respecto al impacto de la exposición de los niños a la violencia - particularmente con respecto a la pérdida de alguna persona importante para ellos - así como el desarrollo de una serie de los programas de prevención de la violencia
Assuntos
Humanos , Masculino , Feminino , Criança , Desenvolvimento Infantil , População Urbana , Violência , Agressão , Análise Multivariada , Instituições Acadêmicas , Fatores Socioeconômicos , Jamaica , Vítimas de CrimeRESUMO
OBJECTIVE: To determine whether changes in primary and secondary care service delivery could prevent antenatal eclampsia. METHOD: One intervention (St. Catherine) and two control (St. Ann, Manchester) parishes were chosen. The health system in St. Catherine was restructured. Primary antenatal clinics had clear instructions for referring patients to a high-risk antenatal clinic or to hospital. Guidelines were provided to high-risk clinics and the antenatal ward for appropriate treatment of hypertension and preeclampsia when induction of labor should occur. Antenatal eclampsia incidence was monitored before and during the intervention and compared with control parishes (no intervention). Each eclampsia case was investigated to identify inadequacies in the system. RESULTS: The process resulted in better identification of women at risk. Antenatal eclampsia incidence dropped dramatically as care improved. Compared with control areas, by completion of the study, the rate was significantly lower than at the start: OR 0.19 (95% CI: 0.13-0.27; p<0.001 trend). Antenatal admissions for hypertensive disorders declined significantly, and the number of bed days halved. CONCLUSION: Reorganization of maternal care can have major public health benefits and cost savings; however, women need to be alerted to recognise and act upon signs of impending eclampsia.