RESUMO
Behavioral health risk factor and health belief data for the indigenous population of the Peruvian Amazon are unavailable. Therefore, we conducted structured interviews of adults living in 5 towns in the remote Amazon region of Peru. Respondents (n = 179) were 67% women with a mean age of 35.4 years. The average household size was 6.7 people. A majority (72%) were unable to see a doctor when needed because of lack of money and distance. Only 6% reported excellent health, and nearly half (49%) reported fair health. Forty-eight percent drank alcohol and 73% smoked. Only 34% thought mosquitoes cause malaria, but 98% were using mosquito nets. In conclusion, our findings indicate the indigenous population of the Peruvian Amazon has limited access to basic health care. Although most of those surveyed use mosquito netting, few know that mosquitoes transmit malaria. Tobacco and alcohol use are major behavioral health risk factors.
Assuntos
Comportamentos Relacionados com a Saúde , Indígenas Sul-Americanos/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas , Terapias Complementares , Escolaridade , Feminino , Educação em Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Indígenas Sul-Americanos/educação , Entrevistas como Assunto , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Peru , População Rural , Saneamento , FumarRESUMO
Beginning in 1983, a sharp increase was noted in the number of new admissions for cocaine abuse to the only psychiatric hospital and to the primary outpatient psychiatric clinic in the Bahamas. For the two facilities combined, new admissions for cocaine abuse increased from none in 1982 to 69 in 1983 and to 523 in 1984. Although there was some evidence for a rise in cocaine use during this time, as the drug became cheaper and more available, a primary cause of this medical epidemic seemed to be a switch by pushers from selling cocaine hydrochloride, which has a low addictive potential, to almost exclusive selling of cocaine free base, which has a very high addictive potential and causes medical and psychological problems. Although the use of free cocaine base is rising around the world, this is the first report of a nationwide medical epidemic due almost exclusively to this form of the drug, although similar problems are reported with smoking coca paste in South America.
Assuntos
Cocaína , Surtos de Doenças/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Aerossóis , Bahamas , Criança , Cocaína/administração & dosagem , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Psicoses Induzidas por Substâncias/etiologia , Estudos RetrospectivosRESUMO
This survey of 99 pregnant teenagers in clinics on the island of New Providence, Bahamas, produced data suggesting that they are similar to their counterparts in urban clinics in the U.S.A. The pregnancies usually came from relationships of many months' standing, which were meaningful to the young mothers, rather than from "promiscuous" sexual behavior. Few of the young mothers had been using birth control before they became pregnant, sometimes because of a lack of expectation of needing it or from fear or ignorance about birth control, and sometimes due to an inability to organize their lives sufficiently to find, purchase, and use regularly the contraception that would have prevented the pregnancy. Most of the young mothers felt that abortion was sinful and would not have used it at any time. It is suggested that these general characteristics of teenage pregnancy are common in Western societies and are related to the perceived loneliness and uselessness of the teenage period. The pregnancies often may be seen as an attempt by teenagers, who see relatively little future for themselves in traditional education and employment, to strive for a creative life rooted in loving relationships.
Assuntos
Gravidez na Adolescência , Adolescente , Adulto , Bahamas , Coeficiente de Natalidade , Feminino , Humanos , Gravidez , Meio Social , Fatores de TempoRESUMO
Beta-thalassemia trait is a frequent cause of microcytic anemia in Mediterranean children. Because striking age-related changes occur in hemoglobin and mean corpuscular volume during childhood, we assessed developmental hematologic characteristics of 132 patients less than or equal to 18 years of age with beta-thalassemia trait. Thirty-nine kindred were studied to examine intrafamilial correlations of hematologic abnormalities. Patients with beta-thalassemia trait demonstrated Hgb values about 2 gm/dl below normal standards, with a progressive rise with age paralleling normal trends. Thalassemic MCV values showed a far greater deviation from normal than Hgb levels. In contrast to normal developmental trends which show a sharp increase in the first five years of life, the MCV in thalassemia trait showed no age-related increase prior to adolescence. No age-related changes in hemoglobin A2 levels were noted. Kindred studies demonstrate a correlation of the degree of anemia, microcytosis, and elevated hemoglobin A2 levels in affected family members (r = 0.318 P < 0.004, r = 0.525 P < 0.001, r = 0.416 P < 0.0015, respectively). Our findings support the use of electronically determined MCV values as an initial screening procedure for children with beta-thalassemia trait. Values of < 70 fl prior to adolescence and < 75 fl during adolescence were present in nearly all thalassemic subjects. Intrafamilial correlations of Hgb, MCV, and hemoglobin A2 levels suggest that these characteristics are genetically determined.