The impact of helmets on motorcycle head trauma at a tertiary hospital in Jamaica

<p>Abstract</p> <p>Background</p> <p>Although the Jamaica road traffic act mandates motorcycle riders to wear approved helmets, opponents suggest that the local road conditions obviate any benefits from helmet use that have been proven in Developed countries. They suggest that the narrow, winding, poorly surfaced, congested local highways do not allow motorcyclists to sustain high velocity travel. The accidents then tend to occur at lower speeds and are accompanied by less severe injuries. This study was carried out to determine the impact of helmet use on traumatic brain injuries from motorcycle collisions in patients admitted to a tertiary referral hospital in Jamaica.</p> <p>Methods</p> <p>A prospectively collected trauma registry maintained by the Department of Surgery at the University Hospital of the West Indies in Jamaica was accessed to identify all motorcycle collision victims from January 2000 to January 2007. The therapeutic outcomes of traumatic brain injuries were compared between helmeted and un-helmeted riders. The data was analyzed using SPSS Version 12.</p> <p>Results</p> <p>Of 293 motorcycle collision victims, 143 sustained brain injuries. There were 9 females (6.3%) with an average age of 23 +/- 7.3 years and 134 males (93.7%) at an average age of 33.4 +/- 11.2 years (mean +/- SD). Only 49 (34.3%) patients wore a helmet at the time of a collision. Helmet use at the time of a collision significantly reduced the severity of head injuries (28.6% vs 46.8%, P = 0.028) and the likelihood of sustaining intra-cranial lesions (26.5% vs 44.7%, P = 0.03) from head injuries.</p> <p>Conclusion</p> <p>Wearing a helmet at the time of a motorcycle collision reduces the severity of head injuries. However, the prevalence of helmet use at the time of a collision is unacceptably low.</p

Household food insecurity and childhood overweight in Jamaica and Québec: a gender-based analysis

Background - Childhood overweight is not restricted to developed countries: a number of lower- and middle-income countries are struggling with the double burden of underweight and overweight. Another public health problem that concerns both developing and, to a lesser extent, developed countries is food insecurity. This study presents a comparative gender-based analysis of the association between household food insecurity and overweight among 10-to-11-year-old children living in the Canadian province of Québec and in the country of Jamaica. // Methods - Analyses were performed using data from the 2008 round of the Québec Longitudinal Study of Child Development and the Jamaica Youth Risk and Resiliency Behaviour Survey of 2007. Cross-sectional data were obtained from 1190 10-year old children in Québec and 1674 10-11-year-old children in Jamaica. Body mass index was derived using anthropometric measurements and overweight was defined using Cole's age- and sex-specific criteria. Questionnaires were used to collect data on food insecurity. The associations were examined using chi-square tests and multivariate regression models were used to estimate odds ratios (OR) and 95% confidence intervals. // Results - The prevalence of overweight was 26% and 11% (p < 0.001) in the Québec and Jamaican samples, respectively. In Québec, the adjusted odds ratio for being overweight was 3.03 (95% CI: 1.8-5.0) among children living in food-insecure households, in comparison to children living in food-secure households. Furthermore, girls who lived in food-insecure households had odds of 4.99 (95% CI: 2.4-10.5) for being overweight in comparison to girls who lived in food-secure households; no such differences were observed among boys. In Jamaica, children who lived in food-insecure households had significantly lower odds (OR 0.65, 95% CI: 0.4-0.9) for being overweight in comparison to children living in food-secure households. No gender differences were observed in the relationship between food-insecurity and overweight/obesity among Jamaican children. // Conclusions - Public health interventions which aim to stem the epidemic of overweight/obesity should consider gender differences and other family factors associated with overweight/obesity in both developed and developing countries

Extending social protection in health in LAC - bridging research and practice : an evaluation of the impact of user fees for preventing care services on health status and coping behaviour of patients in Jamaica

The table of contents for this item can be shared with the requester. The requester may then choose one chapter, up to 10% of the item, as per the Fair Dealing provision of the Canadian Copyright ActThe study was designed to assess the impact of user fees on the level of: utilisation of family planning, immunization and antenatal services; those offered to consumers suffering from diabetes and hypertension; the success of the system of exemptions; services most affected, and coping mechanisms employed. It also aims to develop possible policy options to user fees as well as workable mechanisms that bridge the activities of researchers and policy makers. This detailed report provides analysis of data, findings, recommendations, alternatives and conclusions. An improvement in customer service in the public sector is a necessary requirement

Comparison and Prediction of Preclinical Students' Performance in the MBBS Stage I Examination at the University of the West Indies, Mona Campus

This retrospective study involved the analysis of the grades of ninety-four preclinical students who took the Bachelor of Medicine and Bachelor of Surgery (MBBS) Stage I Examination in Anatomy, Biochemistry, Physiology, Social and Preventive Medicine, and Pharmacology between December1997 and May 1999 at the Mona Campus of The University of the West Indies (UWI). A statistically significant correlation was observed among the basic science subjects. Additionally, a statistically significant prediction was found between the performances of the students in one discipline and the others, with Physiology being the most predicted. The data support the hypothesis that students who performed well in one discipline were likely to perform well in the other disciplines; and also that the performance in some subjects could predict the performance in others. This result may also justify further investigation as to whether the performance in certain basic sciences disciplines at the preclinical stage can be used to predict performance in the clinical disciplines

The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire was equivalent to clinical assessment in identifying children with epilepsy

Objectives To assess the validity and reliability of a screening questionnaire administered to parents/caregivers to detect behaviors suggestive of epileptic seizures in children. Study Design and Setting We developed a 10-item questionnaire, which was administered to 120 parents/caregivers of children attending hospital-based clinics/pediatric neurologists\u27 offices. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminant ability of the questionnaire and determine cutoff points. Questionnaire sensitivity and specificity were compared with clinical assessment by a pediatrician and pediatric neurologist. The questionnaire was readministered to 25 parents/caregivers after 1 month to assess reliability. Results The 120 children had the following characteristics: 58% with epilepsy, 55% male, mean (standard deviation) age 8.1 (3.2) years. A positive response to ≥1 item had the highest sensitivity (89%) and specificity (91%), with a ROC area under curve of 0.91 (95% confidence interval: 0.86, 0.97). The validity of the questionnaire was similar to the clinical evaluation by the pediatric neurologist and pediatrician. The Spearman correlation coefficient for the total score from repeat administration of the questionnaire was 0.95 (P \u3c 0.01). Conclusion The UWIMONA Pediatric Epileptic Seizure Screening Questionnaire is a valid and reliable screening instrument and performed similarly when compared with evaluation by an experienced clinician