1
|
McKenzie JA, Younger NO, Tulloch-Reid MK, Govia I, Bennett NR, McFarlane S, Walters R, Francis DK, Webster-Kerr K, Grant A, Davidson T, Wilks R, Williams DR, Ferguson TS. Ideal cardiovascular health in urban Jamaica: prevalence estimates and relationship to community property value, household assets and educational attainment: a cross-sectional study. BMJ Open 2020; 10:e040664. [PMID: 33323436 PMCID: PMC7745314 DOI: 10.1136/bmjopen-2020-040664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES). DESIGN Cross-sectional study. SETTING Urban communities in Jamaica. PARTICIPANTS 360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016-2017. EXPOSURES Community SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level. PRIMARY OUTCOME The main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations. RESULTS The prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. CONCLUSION Living in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.
Collapse
Affiliation(s)
- Joette A McKenzie
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Novie O Younger
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Marshall Kerr Tulloch-Reid
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Nadia R Bennett
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Shelly McFarlane
- Tropical Metabolism Research Unit, Caribbean Institute for Health Research, University of the West Indies at Mona, Kingston, Saint Andrew, Jamaica
| | - Renee Walters
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - Damian K Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, Georgia, USA
| | - Karen Webster-Kerr
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Andriene Grant
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Tamu Davidson
- Office of the Prinicpal Medical Officer, National Epidemiology Unit and Non-Communicable Diseases and Injuries Prevention Unit, Ministry of Health and Wellness, Kingston, Jamaica
| | - Rainford Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| |
Collapse
|
2
|
Cunningham-Myrie CA, Younger NO, Theall KP, Greene LG, Lyew-Ayee P, Wilks R. Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study. BMJ Open 2020; 10:e033839. [PMID: 32830113 PMCID: PMC7445353 DOI: 10.1136/bmjopen-2019-033839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity. DESIGN Cross-sectional study. SETTING Data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts. PARTICIPANTS A subsample of 2529 participants aged 18-74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded. PRIMARY OUTCOME MEASURE Mean BMI, calculated as weight divided by height squared (kg/m2). RESULTS There was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10-3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity. CONCLUSIONS Higher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.
Collapse
Affiliation(s)
| | - Novie O Younger
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Katherine P Theall
- Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana, USA
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| |
Collapse
|
3
|
Cunningham-Myrie CA, Mabile E, Govia I, Younger NO, Tulloch-Reid MK, McFarlane S, Francis D, Gordon-Strachan G, Wilks R, Greene LG, Lyew-Ayee P, Theall KP. Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study. BMJ Open 2018; 8:e021952. [PMID: 30552247 PMCID: PMC6303643 DOI: 10.1136/bmjopen-2018-021952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 08/11/2018] [Accepted: 10/04/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs). DESIGN Cross-sectional study SETTING: A population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs). PARTICIPANTS 2544 persons aged 15-74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded. PRIMARY OUTCOME A summary measure CBR was created using seven markers-systolic and diastolic blood pressure readings, waist circumference, body mass index, total cholesterol, fasting blood glucose levels and self-reported asthma. Weighted multilevel models examined clustering, using the intraclass correlation coefficient (ICC), of CBR across neighbourhoods and the impact of neighbourhood characteristics (recreational space availability and neighbourhood disorder) on CBR. RESULTS Women had significantly higher mean CBR scores than men across all age groups. There was significant clustering of CBR by ED, and among women versus men (ICC: F=6.9%, M=0.7%). Women living in more disordered neighbourhoods were 26% more likely to have high CBR as those in less disordered ones (aOR=1.26, 95% CI=1.08 to 1.47; p<0.05). Individuals living in EDs with greater recreational space availability were 25% less likely to have a high CBR (aOR=0.75, 95% CI=0.64 to 0.90; p<0.05). CONCLUSIONS Policy-makers in Jamaica should pay greater attention to neighbourhood factors such as recreational space availability and neighbourhood disorder that may contribute to CBR in any effort to curtail the epidemic of NCDs.
Collapse
Affiliation(s)
| | - Emily Mabile
- Louisiana Department of Health, Office of Public Health, Bureau of Family Health, Baton Rouge, Louisiana, USA
| | - Ishtar Govia
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Novie O Younger
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Shelly McFarlane
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Damian Francis
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | | | - Rainford Wilks
- Caribbean Institute for Health Research, University of the West Indies, Mona, Jamaica
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Jamaica
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| |
Collapse
|
4
|
Cunningham-Myrie CA, Theall KP, Younger NO, Mabile EA, Tulloch-Reid MK, Francis DK, McFarlane SR, Gordon-Strachan GM, Wilks RJ. Associations between neighborhood effects and physical activity, obesity, and diabetes: The Jamaica Health and Lifestyle Survey 2008. J Clin Epidemiol 2015; 68:970-8. [PMID: 25910912 DOI: 10.1016/j.jclinepi.2014.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 08/07/2014] [Accepted: 08/07/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the impact of neighborhood disorder, perceived neighborhood safety, and availability of recreational facilities on prevalence of physical activity (PA), obesity, and diabetes mellitus (DM). STUDY DESIGN AND SETTING Multilevel analyses were conducted among 2,848 respondents from the 2007-08 Jamaica Health and Lifestyle Survey. Neighborhood effects were based on aggregated interviewer responses to systematic social observation questions. Mixed-effect logistic regression models were created to assess the relationship between neighborhood indicators and DM and the modifiable risk factors PA and overweight/obesity. RESULTS There was significant clustering in PA levels of 20 minutes at least once per week (intraclass correlation coefficient [ICC] = 10.7%), low/no PA (ICC = 7.22%), diabetes (ICC = 5.44%), and obesity (ICC = 3.33%) across neighborhoods. Greater levels of neighborhood disorder, home disorder, and counterintuitively recreational space availability were associated with higher levels of low/no PA among women. There was significant interaction by sex between neighborhood infrastructure and overweight/obesity with a significant association in men (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 1.05, 1.28) but not women (OR = 1.01; 95% CI = 0.95, 1.07). CONCLUSION Differences in PA and obesity-related outcomes among Jamaicans may be partially explained by characteristics of the neighborhood environment and differ by sex. Future studies must be conducted to determine the mechanistic pathways through which the neighborhood environment may impact such outcomes to better inform prevention efforts.
Collapse
Affiliation(s)
- Colette Andrea Cunningham-Myrie
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Kingston 7, Jamaica; Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica.
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Novie O Younger
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Emily A Mabile
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Marshall K Tulloch-Reid
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Damian K Francis
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Shelly R McFarlane
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | | | - Rainford J Wilks
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| |
Collapse
|
5
|
Tulloch-Reid MK, Younger NO, Ferguson TS, Francis DK, Abdulkadri AO, Gordon-Strachan GM, McFarlane SR, Cunningham-Myrie CA, Wilks RJ, Anderson SG. Excess Cardiovascular Risk Burden in Jamaican Women Does Not Influence Predicted 10-Year CVD Risk Profiles of Jamaica Adults: An Analysis of the 2007/08 Jamaica Health and Lifestyle Survey. PLoS One 2013; 8:e66625. [PMID: 23805252 PMCID: PMC3689813 DOI: 10.1371/journal.pone.0066625] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 05/08/2013] [Indexed: 01/03/2023] Open
Abstract
Background Black Caribbean women have a higher burden of cardiovascular disease (CVD) risk factors than their male counterparts. Whether this results in a difference in incident cardiovascular events is unknown. The aim of this study was to estimate the 10 year World Health Organization/International Society for Hypertension (WHO/ISH) CVD risk score for Jamaica and explore the effect of sex as well as obesity, physical activity and socioeconomic status on these estimates. Methods and Findings Data from 40–74 year old participants in the 2007/08 Jamaica Health and Lifestyle Survey were used. Trained interviewers administered questionnaires and measured anthropometrics, blood pressure, fasting glucose and cholesterol. Education and occupation were used to assess socioeconomic status. The Americas B tables were used to estimate the WHO/ISH 10 year CVD risk scores for the population. Weighted prevalence estimates were calculated. Data from 1,432 (450 men, 982 women) participants were analysed, after excluding those with self-reported heart attack and stroke. The women had a higher prevalence of diabetes (19%W;12%M), hypertension (49%W;47%M), hypercholesterolemia (25%W;11%M), obesity (46%W;15%M) and physical inactivity (59%W;29%M). More men smoked (6%W;31%M). There was good agreement between the 10-year cardiovascular risk estimates whether or not cholesterol measurements were utilized for calculation (kappa –0.61). While 90% had a 10 year WHO/ISH CVD risk of less than 10%, approximately 2% of the population or 14,000 persons had a 10 year WHO/ISH CVD risk of ≥30%. As expected CVD risk increased with age but there was no sex difference in CVD risk distribution despite women having a greater risk factor burden. Women with low socioeconomic status had the most adverse CVD risk profile. Conclusion Despite women having a higher prevalence of CVD risk factors there was no sex difference in 10-year WHO/ISH CVD risk in Jamaican adults.
Collapse
Affiliation(s)
- Marshall K. Tulloch-Reid
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
- * E-mail:
| | - Novie O. Younger
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Trevor S. Ferguson
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Damian K. Francis
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | | | | | - Shelly R. McFarlane
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | | | - Rainford J. Wilks
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Simon G. Anderson
- Institute of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
6
|
Gayle KAT, Tulloch Reid MK, Younger NO, Francis DK, McFarlane SR, Wright-Pascoe RA, Boyne MS, Wilks RJ, Ferguson TS. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica. Clin Pract 2012; 2:e85. [PMID: 24765484 PMCID: PMC3981191 DOI: 10.4081/cp.2012.e85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 08/16/2012] [Accepted: 08/30/2012] [Indexed: 12/30/2022] Open
Abstract
This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90%) reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. Approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82%) or leather shoes (64%), fairly high proportions reported wearing pointed toe shoes (39%), and 43% of women wore high heel shoes. In conclusion, approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided.
Collapse
|
7
|
Kahwa EK, Waldron NK, Younger NO, Edwards NC, Knight-Madden JM, Bailey KA, Wint YB, Lewis-Bell KN. Asthma and allergies in Jamaican children aged 2-17 years: a cross-sectional prevalence survey. BMJ Open 2012; 2:e001132. [PMID: 22798254 PMCID: PMC3400072 DOI: 10.1136/bmjopen-2012-001132] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 06/06/2012] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To determine the prevalence and severity of asthma and allergies as well as risk factors for asthma among Jamaican children aged 2-17 years. DESIGN A cross-sectional, community-based prevalence survey using the International Study of Asthma and Allergies in Childhood questionnaire. The authors selected a representative sample of 2017 children using stratified, multistage cluster sampling design using enumeration districts as primary sampling units. SETTING Jamaica, a Caribbean island with a total population of approximately 2.6 million, geographically divided into 14 parishes. PARTICIPANTS Children aged 2-17 years, who were resident in private households. Institutionalised children such as those in boarding schools and hospitals were excluded from the survey. PRIMARY AND SECONDARY OUTCOME MEASURES The prevalence and severity of asthma and allergy symptoms, doctor-diagnosed asthma and risk factors for asthma. RESULTS Almost a fifth (19.6%) of Jamaican children aged 2-17 years had current wheeze, while 16.7% had self-reported doctor-diagnosed asthma. Both were more common among males than among females. The prevalence of rhinitis, hay fever and eczema among children was 24.5%, 25% and 17.3%, respectively. Current wheeze was more common among children with rhinitis in the last 12 months (44.3% vs 12.6%, p<0.001), hay fever (36.8% vs 13.8%, p<0.001) and eczema (34.1% vs 16.4%, p<0.001). Independent risk factors for current wheeze (ORs, 95% CI) were chest infections in the first year of life 4.83 (3.00 to 7.77), parental asthma 4.19 (2.8 to 6.08), rhinitis in the last 12 months 6.92 (5.16 to 9.29), hay fever 4.82 (3.62 to 6.41), moulds in the home 2.25 (1.16 to 4.45), cat in the home 2.44 (1.66 to 3.58) and dog in the home 1.81 (1.18 to 2.78). CONCLUSIONS The prevalence of asthma and allergies in Jamaican children is high. Significant risk factors for asthma include chest infections in the first year of life, a history of asthma in the family, allergies, moulds and pets in the home.
Collapse
Affiliation(s)
- Eulalia K Kahwa
- The UWI School of Nursing, Mona, University of the West Indies, Kingston, Jamaica
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Cumberbatch CG, Younger NO, Ferguson TS, McFarlane SR, Francis DK, Wilks RJ, Tulloch-Reid MK. Reported hours of sleep, diabetes prevalence and glucose control in jamaican adults: analysis from the Jamaica lifestyle survey 2007-2008. Int J Endocrinol 2011; 2011:716214. [PMID: 22164161 PMCID: PMC3227472 DOI: 10.1155/2011/716214] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 09/06/2011] [Indexed: 11/17/2022] Open
Abstract
Background. There are limited data on sleep duration and diabetes from developing countries. We therefore examined the relationship between reported hours of sleep, diabetes prevalence and glucose control in Jamaican adults. Methods. Data on reported hours of sleep and diabetes (based on glucose measurement and medication use) from a national survey of 15-74-year-old Jamaicans were analyzed. Results. The 2,432 participants (31% M, Age 42 ± 16 years, BMI 27.6 ± 6.6 kg/m(2), diabetes prevalence 12%) reported sleeping 8.2 ± 1.8 hours. In men, sleeping less than 6 hours (OR (95% CI) = 2.65 (1.09-6.48)) or more than 10 hours (OR (95% CI) = 4.36 (1.56-12.19)) was associated with diabetes when adjusted for age, BMI, and family history of diabetes. In women sleeping less than 6 hours was associated with a reduced likelihood of diabetes after adjusting for the same confounders ((OR (95% CI) = 0.43 (0.23-0.78)). There was no significant association between sleep and glucose control. Conclusion. Insufficient and excessive sleep was associated with increased diabetes prevalence in Jamaican men but not women.
Collapse
Affiliation(s)
- Chisa G. Cumberbatch
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Novie O. Younger
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Trevor S. Ferguson
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Shelly R. McFarlane
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Damian K. Francis
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Rainford J. Wilks
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Marshall K. Tulloch-Reid
- Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston 7, Mona, Jamaica
| |
Collapse
|
9
|
Ferguson TS, Tulloch-Reid MK, Younger NO, McFarlane SR, Francis DK, Wilks RJ. Prehypertension in Jamaica: a review of data from recent studies. W INDIAN MED J 2011; 60:429-433. [PMID: 22097673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Prehypertension is defined as a systolic blood pressure of 120-139 mmHg or diastolic blood pressure of 80-89 mmHg in patients not on medication for hypertension. Recent studies have shown that prehypertension has a high prevalence in both western and eastern countries and is associated with cardiovascular disease (CVD) risk factors, incident CVD and CVD mortality. We reviewed data from ongoing epidemiological studies in Jamaica in order to provide an update on the prevalence and predictors of prehypertension in Jamaica. Studies included were the Jamaica Health and Lifestyle Surveys (2000-2001 and 2007-2008), the Jamaica Youth Risk and Resiliency Behaviour Survey 2006, the 1986 Jamaica Birth Cohort Study and the Spanish Town Cohort Study. The prevalence of prehypertension in the most recent national survey was 35% (95% CI 33, 38%). Prevalence was higher in men compared to women (42% versus 29%). Jamaicans with prehypertension were more likely to have other CVD risk factors and were three times more likely to develop hypertension compared with persons with a normal blood pressure. Prevalence was also high among youth, particularly males. Longitudinal analysis from the 1986 birth cohort suggested that prehypertension may be more common in persons with low birthweight or short birth length. Physicians and public health practitioners should recognize the increased CVD risk associated with prehypertension and should begin to institute CVD prevention measures in persons with prehypertension. Sex differences and the early onset of prehypertension in men require further exploration.
Collapse
Affiliation(s)
- T S Ferguson
- Tropical Medicine Research Institute (Epidemiology Research Unit), The University of the West Indies, Kingston 7, Jamaica.
| | | | | | | | | | | |
Collapse
|
10
|
Pepple DJ, Richards AA, Lowe DA, Reid WA, Younger NO, Williams LAD. In vitro erythrocytic membrane effects of dibenzyl trisulfide, a secondary metabolite of Petiveria alliacea. Fitoterapia 2010; 81:1113-6. [PMID: 20627119 DOI: 10.1016/j.fitote.2010.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/01/2010] [Accepted: 07/05/2010] [Indexed: 11/28/2022]
Abstract
We investigated the in vitro effect of dibenzyl trisulfide (DTS), a secondary metabolite of Petiveria alliacea, on erythrocyte elasticity, relaxation time and membrane morphology. Blood samples from 8 volunteers with hemoglobin AA were exposed to 100, 200, 400, 800 and 1000 ng/ml of DTS respectively and the elasticity and relaxation time measured. There were statistically significant, dose-dependent increases in elasticity and relaxation times. The changes in membrane morphology observed also increased with increased concentration of DTS. This suggests that DTS interaction with membrane protein resulted in increased elasticity, relaxation time and deformation of the erythrocyte membrane.
Collapse
Affiliation(s)
- D J Pepple
- Department of Basic Medical Sciences, Physiology Section, The University of the West Indies, Mona Campus, Jamaica.
| | | | | | | | | | | |
Collapse
|
11
|
Ferguson TS, Tulloch-Reid MK, Younger NO, Boyne MS, Wright-Pascoe RA, Elliott VE, Van den Broeck J, Wilks RJ. Cardiovascular disease among diabetic in-patients at a tertiary hospital in Jamaica. Diab Vasc Dis Res 2010; 7:241-2. [PMID: 20587600 DOI: 10.1177/1479164110374750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
12
|
Kahwa EK, Younger NO, Wint YB, Waldron NK, Hewitt HH, Knight-Madden JM, Bailey KA, Edwards NC, Talabere LR, Lewis-Bell KN. The Jamaica asthma and allergies national prevalence survey: rationale and methods. BMC Med Res Methodol 2010; 10:29. [PMID: 20361871 PMCID: PMC2861068 DOI: 10.1186/1471-2288-10-29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 04/03/2010] [Indexed: 11/10/2022] Open
Abstract
Background Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. Methods/Design An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates. Discussion The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.
Collapse
|
13
|
Landen CN, Younger NO, Collins Sharp BA, Underwood PB. Cancer patients' satisfaction with physicians: Princess Margaret Hospital Satisfaction with Doctor Questionnaire results. Am J Obstet Gynecol 2003; 188:1177-9. [PMID: 12748470 DOI: 10.1067/mob.2003.281] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The study was performed to examine the satisfaction of a specific population of oncology patients with their physicians and to quantify its association with characteristics of their disease. STUDY DESIGN A descriptive design was used in which patients attending a weekend cancer support retreat completed the Princess Margaret Hospital Satisfaction with Doctor Questionnaire (PMH-PSQ-MD). Demographic information was requested separately. RESULTS Of 48 patients, 96% completed the PMH-PSQ-MD, and 67% mailed in the additional demographics. Average overall score was 3.08 (SD = 0.56, 4 being most satisfied). Patients reported a desire for more time with physicians and that their pain be better understood. Patients were most satisfied with the physician's honesty, thoroughness, and communication. Satisfaction scores did not correlate with intensity of treatment or time since diagnosis. Scores declined as financial burden of therapy increased, but the trend was not statistically significant. CONCLUSION Patients attending this retreat were generally satisfied with their physicians, regardless of treatment intensity. Increasing financial burden may be associated with physician dissatisfaction.
Collapse
Affiliation(s)
- Charles N Landen
- Department of Obstetrics and Gynecology, Medical University of South Carolina, 96 Jonathan Lucas Boulevard, 634 CSB, Charleston, SC 29425, USA
| | | | | | | |
Collapse
|