The University of the West Indies at Mona, Jamaica: UWI Journals
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Seroprevalence of Trypanosoma cruzi in Blood Donors at the National Blood Transfusion Services―Guyana
No full textIntroduction: Blood transfusion is an important transmission route of Trypanosoma cruzi (T cruzi), a major parasitic infection in Central and South America. The limited treatment options are most effective in acute Chagas’ infection. At present, there is no current data on the prevalence of T cruzi in the blood donor population of Guyana. This information is necessary to protect the supply of the blood donation programme.
This study sought to determine the prevalence of T cruzi in the blood supply at the National Blood Transfusion Services of Guyana with the hope of providing knowledge to the on-going surveillance for Chagas’ disease worldwide and therefore address the risk of its spread by blood transfusion.
Methods: Two commercialized ELISAs utilizing crude or recombinant T cruzi antigens were used to study 2000 blood samples voluntarily donated for the purpose of altruistic or family replacement donation retrospectively.
Results: The results showed that approximately 1 in 286 donations tested positive for antibodies to T cruzi.
Conclusion: These results indicate that T cruzi continues to be a risk in Guyana and there is a need to continue screening donated blood. Trypanosoma cruzi is a life-long infection and infected persons may be asymptomatic chronic carriers of the disease. Education, housing improvement, and controlled use of insecticides should be introduced to contain Chagas’ disease.
Keywords: Chagas’ disease, blood donor screening, enzyme-linked immunosorbent assay (ELISA), transfusion-transmissio
Orthodontic Manpower Requirements of Trinidad and Tobago
No full textObjective: A study was done to estimate the orthodontic manpower requirements of Trinidad and Tobago.
Methods: A questionnaire was administered via e-mail to 9 of 11 orthodontists. Information from a population census, a report on the orthodontic treatment needs of children in Trinidad and Tobago and this questionnaire were used to calculate the number of orthodontists and chairside orthodontic assistants needed in Trinidad and Tobago.
Results: On average, 50 per cent of the 289 patients treated by each orthodontist in Trinidad and Tobago annually are children. Approximately, 13 360 patients can be expected to demand orthodontic treatment every year in this country. The number of orthodontists and chairside assistants required to treat these patients was estimated to be 44 and 154, respectively.
Conclusions: Currently, Trinidad and Tobago only has a quarter of the number of orthodontists and orthodontic chairside assistants required to treat the number of patients in need. As the demand is relatively high in Trinidad and Tobago and the number of orthodontists has increased slowly and inadequately for the past decade, the orthodontists are likely to remain adequately employed and happy with their job unlike dentists who are currently in private practice for less than a year.
Keywords: Index of Orthodontic Treatment Need (IOTN), manpower, orthodontic assistant, orthodontis
Using Receiver Operating Characteristic Curve Analysis in Detecting Excess Adiposity in 9-13-year Old South African Children
No full textObjective: Little is known concerning the applicability of receiver operating characteristic (ROC) curve analysis in detecting excess adiposity in preadolescent South African children. Therefore the purpose of this study was to evaluate the sensitivity and specificity of body mass index (BMI) and skinfold thickness:BMI (subcutaneous to overall fat) in detecting excess adiposity in preadolescent urban South African school children.
Methods: This was a cross-sectional survey of 1136 randomly selected children (548 boys and 588 girls) aged 9-13 years old in urban (Pretoria Central) South Africa. Body mass, stature, skinfolds (subscapular, triceps, supraspinale and biceps) and waist circumference were measured. Receiver operating characteristic curve analysis was used to assess the sensitivity and specificity of BMI, and log10 SF4:BMI to detect excess adiposity. Excess adiposity was defined as levels of log10 SF4 greater than the internally derived 85th percentile (log10 SF4 > 85th percentile).
Results: Compared to log10 SF4:BMI, BMI had a high specificity (0.88; 95% CI 0.84, 0.90). The log10 SF4:BMI identified excess adiposity with a sensitivity and specificity of 0.62 (95% CI 0.60, 0.67) and 0.68 (95% CI 0.64, 0.70), respectively. Besides, a decrease in overall misclassification with the use of log10 SF4:BMI instead of BMI at the 95th percentile (9.7% versus 27.1%) was observed.
Conclusion: Similar to other studies, although with varying degrees, the present study confirms that log10 SF4:BMI at conventional cut-off points has a relatively high sensitivity and specificity in detecting excess adiposity, and therefore could be used to identify the excess adiposity in South African children. As such, defining obesity based on population-specific percentiles rather than using cut-off points derived from other geographical settings with contrasting levels of socio-economic development becomes imperative.
Keywords: Adiposity, body mass index, children, obesity, receiver operating characteristic (ROC) curve analysis, sensitivity, specificit
Minimally Invasive Surgery Training in the Caribbean – A Survey of General Surgical Residents and Their Trainers
No full textBackground: There has been debate as to the feasibility of incorporating minimally invasive surgery (MIS) into surgical practice in developing countries due to resource and training limitations. Our study establishes the current and desired state of MIS training in surgical residency programmes in the Caribbean.
Methods: An adapted version of a previously administered questionnaire was issued to surgeons and residents involved in the general surgical residency programme of The University of the West Indies in Barbados, Jamaica and Trinidad and Tobago. Data were analysed using the Statistical Package for the Social Sciences, version 17.0.
Results: The questionnaire was sent to 41 surgeons and 41 residents with a 65% response rate. Most residents had performed less than 25 basic laparoscopic procedures. Up to 82% of residents felt that they would be unable to perform advanced laparoscopic procedures due to lack of training. The principal negative factors influencing MIS training included lack of operating room time, lack of equipment and lack of preceptor expertise. Both surgeons (83.4%) and residents (93.4%) strongly felt that a surgical skills laboratory would be helpful for the acquisition of MIS skills. Both surgeons (85.7%) and residents (100%) felt that there was a role for an MIS surgeon in fulfilling training obligations.
Conclusion: The basic and advanced MIS experience of residents in the Caribbean is limited. Surgeon training and resource limitations are major contributing factors. There is a strong desire on the part of surgeons and residents alike for the incorporation of more effective MIS training into the residency programme in the Caribbean
Keywords: Caribbean, developing, laparoscopy, residents, survey, trainin
An Issue to Keep in Mind Regarding Specific Suicide Prevention Measures Focussing on Bipolar Disorder
No full textThe Relationship between Suicide and Five Climate Issues in a Large-scale and Long Term Study in Japan
No full textObjective: Suicide rates in Japan were high in 1998 and have remained high since then. Many re-searchers have discussed the current state of suicide in Japan and the world; however, there are various opinions about the relationship between suicide and climate.
Subjects and Method: In the present study, we report on long-term data of suicide and examine five climatic issues in Japan as a whole and in 10 selected prefectures: the five with the highest suicide rates in 2006 (Akita, Iwate, Shimane, Yamagata and Miyazaki Prefectures) and the five with the lowest (Nara, Tokushima, Okayama, Kanagawa and Kyoto Prefectures).
Results: Annual age-adjusted suicide rates were found to have a significant inverse correlation with annual mean air temperature in the five prefectures with the highest suicide rates and in the three prefectures with the lowest suicide rates among women. Annual age-adjusted suicide rates were significantly correlated with annual mean relative humidity in the three prefectures with the highest suicide rates among women and with the annual total sunshine duration in the three prefectures with the highest suicide rates among women.
Conclusion: It is important that these associations between suicide and climatic factors be discussed further from various viewpoints, including those of many researchers and relevant organizations.
Keywords: Climate, long term, suicide
"La Relación entre el Suicidio y Cinco Problemas Climáticos en un Estudio a Gran Escala y a Largo Plazo en Japón"
RESUMEN
Objetivo: Las tasas de suicidio en Japón eran altas en 1998, y han permanecido altas desde entonces. Muchos investigadores han discutido el estado actual del suicidio en Japón y el mundo, Como parte de esa discusión, existen diversas opiniones acerca de la relación entre el suicidio y el clima.
Sujetos y método: El presente estudio presente constituye un reporte de datos a largo plazo sobre el suicidio y examina cinco problemas climáticos del Japón en su conjunto así como en 10 prefecturas seleccionadas: las cinco con las más altas tasas de suicidio en 2006 (las prefecturas de Akita, Iwate, Shimane, Yamagata y Miyazaki) y las cinco con las tasas más bajas (Nara, Tokushima, Okayama, Kanagawa y Kyoto).
Resultados: Se halló que las tasas de suicidio ajustadas por edad anualmente presentaban una correlación inversa significativa con la temperatura promedio anual del aire en las cinco prefecturas con las tasas de suicidio más altas y en las tres prefecturas con las tasas de suicidio más bajas entre las mujeres. Las tasas de suicidio anual ajustadas por edad guardaban una correlación significativa con la humedad relativa promedio anual en las tres prefecturas con las tasas del suicidio más altas entre las mujeres y con la duración total anual de sol en las tres prefecturas con las tasas del suicidio más altas entre las mujeres.
Conclusión: Es importante continuar analizando estas asociaciones entre el suicidio y los factores climáticos desde varios puntos de vista, incluyendo aquéllos de muchos investigadores y organizaciones pertinentes.
Palabras claves: clima, a largo plazo, suicidi