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Er V, Lane JA, Martin RM, Persad R, Chinegwundoh F, Njoku V, Sutton E. Barriers and facilitators to healthy lifestyle and acceptability of a dietary and physical activity intervention among African Caribbean prostate cancer survivors in the UK: a qualitative study. BMJ Open 2017; 7:e017217. [PMID: 29038181 PMCID: PMC5652511 DOI: 10.1136/bmjopen-2017-017217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Diet and lifestyle may have a role in delaying prostate cancer progression, but little is known about the health behaviours of Black British prostate cancer survivors despite this group having a higher prostate cancer mortality rate than their White counterparts. We explored the barriers and facilitators to dietary and lifestyle changes and the acceptability of a diet and physical activity intervention in African Caribbean prostate cancer survivors. DESIGN We conducted semistructured in-depth interviews and used thematic analysis to code and group the data. PARTICIPANTS AND SETTING We recruited 14 African Caribbean prostate cancer survivors via letter or at oncology follow-up appointments using purposive and convenience sampling. RESULTS A prostate cancer diagnosis did not trigger dietary and lifestyle changes in most men. This lack of change was underpinned by five themes: precancer diet and lifestyle, evidence, coping with prostate cancer, ageing, and autonomy. Men perceived their diet and lifestyle to be healthy and were uncertain about the therapeutic benefits of these factors on prostate cancer recurrence. They considered a lifestyle intervention as unnecessary because their prostate-specific antigen (PSA) level was kept under control by the treatments they had received. They believed dietary and lifestyle changes should be self-initiated and motivated, but were willing to make additional changes if they were perceived to be beneficial to health. Nonetheless, some men cited advice from health professionals and social support in coping with prostate cancer as facilitators to positive dietary and lifestyle changes. A prostate cancer diagnosis and ageing also heightened men's awareness of their health, particularly in regards to their body weight. CONCLUSIONS A dietary and physical activity intervention framed as helping men to regain fitness and aid post-treatment recovery aimed at men with elevated PSA may be appealing and acceptable to African Caribbean prostate cancer survivors.
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Affiliation(s)
- Vanessa Er
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Athene Lane
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR Bristol Nutrition Biomedical Research Unit, University Hospitals Bristol Education & Research Centre, Bristol, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- NIHR Bristol Nutrition Biomedical Research Unit, University Hospitals Bristol Education & Research Centre, Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol, UK
| | - Raj Persad
- Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Frank Chinegwundoh
- Department of Urology, Barts Health NHS Trust, The Royal London Hospital, London, UK
- School of Health Sciences, University of London, London, UK
| | - Victoria Njoku
- Department of Urology, Barts Health NHS Trust, The Royal London Hospital, London, UK
| | - Eileen Sutton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Andall-Brereton G, Brown E, Slater S, Holder Y, Luciani S, Lewis M, Irons B. Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries. Rev Panam Salud Publica 2017. [PMID: 28614466 PMCID: PMC6660866 DOI: 10.26633/rpsp.2017.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines. METHODS Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines. RESULTS High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV. CONCLUSIONS These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study's results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.
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Affiliation(s)
- Glennis Andall-Brereton
- Caribbean Public Health AgencyCaribbean Public Health AgencyPort-of-SpainTrinidad and TobagoCaribbean Public Health Agency, Port-of-Spain, Trinidad and Tobago.
| | - Eulynis Brown
- Ministry of HealthMinistry of HealthSaint Kitts and NevisMinistry of Health, Saint Kitts and Nevis, Basseterre, Saint Kitts and Nevis.
| | - Sherian Slater
- Ministry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the EnvironmentMinistry of Health, Wellness and the Environment, Saint Vincent and the Grenadines, Kingstown, Saint Vincent and the Grenadines.
| | - Yvette Holder
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.,Send correspondence to Beryl Irons: ,
| | - Silvana Luciani
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Merle Lewis
- Pan American Health OrganizationPan American Health OrganizationWashingtonUnited States of AmericaPan American Health Organization, Washington, D.C., United States of America.
| | - Beryl Irons
- Office of Eastern Caribbean CoordinationPan American Health Organization/World Health OrganizationBarbadosOffice of Eastern Caribbean Coordination, Pan American Health Organization/World Health Organization, Bridgetown, Barbados.
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Nathaniel S, Ahmed S, Wilson J, Gutierrez C, Chadee DD, Olowokure B, de Salazar PM. First reported enterovirus D68 infection in pediatric patients from the Caribbean region: evidence of spread from the U.S. outbreak. Rev Panam Salud Publica 2017; 41:e11. [PMID: 28443999 PMCID: PMC6660861 DOI: 10.26633/rpsp.2017.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The 2014 enterovirus D68 (EV-D68) outbreak in the United States raised concerns about the introduction of the virus in the Caribbean region. The objective of this study was to provide rapid evidence of the introduction of EV-D68 strains in the Caribbean region during the 2014 outbreak in the United States, using a relatively simple phylogenetic approach. From October 2014 to May 2015, four EV-D68 cases from two countries (Bermuda and Dominica) were detected at the regional referral laboratory at the Caribbean Public Health Agency (Port of Spain, Trinidad and Tobago) based on molecular testing of respiratory specimens. All cases were children presenting to hospitals with moderate respiratory distress. No cases of acute flaccid paralysis were detected. Phylogenetic analysis of the Caribbean strains showed more than 99% similarity with the 2014 U.S.-outbreak strain, providing evidence of the introduction and circulation of the virus in the region.
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Affiliation(s)
- SueMin Nathaniel
- Caribbean Public Health AgencyPort of SpainTrinidad and TobagoCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.,Send correspondence to: Pablo Martínez de Salazar,
| | - Shalauddin Ahmed
- Ministry of Health and the EnvironmentRoseauCommonwealth of DominicaMinistry of Health and the Environment, Roseau, Commonwealth of Dominica.
| | - Jennifer Wilson
- Ministry of HealthSeniors and EnvironmentHamiltonBermudaMinistry of Health, Seniors and Environment, Hamilton, Bermuda.
| | - Cristina Gutierrez
- Caribbean Public Health AgencyPort of SpainTrinidad and TobagoCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.
| | - Dave D. Chadee
- University of the West IndiesSt. AugustineTrinidad and TobagoUniversity of the West Indies, St. Augustine, Trinidad and Tobago.
| | - Babatunde Olowokure
- Caribbean Public Health AgencyPort of SpainTrinidad and TobagoCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.
| | - Pablo M. de Salazar
- Caribbean Public Health AgencyPort of SpainTrinidad and TobagoCaribbean Public Health Agency, Port of Spain, Trinidad and Tobago.
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Baker BJ, Peterson B, Mohanlall J, Singh S, Hicks C, Jacobs R, Ramos R, Allen B, Pevzner E. Scale-up of collaborative TB/HIV activities in Guyana. Rev Panam Salud Publica 2017. [PMID: 28444006 PMCID: PMC6660869 DOI: 10.26633/rpsp.2017.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess scale-up of recommended tuberculosis (TB)/HIV activities in Guyana and to identify specific strategies for further expansion. METHODS Medical records and clinic registers were reviewed at nine TB clinics and 10 HIV clinics. At TB clinics, data were collected on HIV testing and antiretroviral therapy (ART) for patients with TB/HIV; at HIV clinics, data were collected on intensified case finding (ICF), tuberculin skin test (TST) results, and provision of isoniazid preventive therapy (IPT). RESULTS At TB clinics, among 461 patients newly diagnosed with TB, 419 (90.9%) had a known HIV status and 121 (28.9%) were HIV-infected. Among the 63 patients with TB/HIV, 33 (52.4%) received ART. Among the 45 patients with TB/HIV for whom dates of HIV diagnosis were available, 38 (84.4%) individuals knew their HIV status prior to TB diagnosis. At HIV clinics, among 127 patients eligible to receive a TST, 87 (68.5%) received a TST, 66 (75.9%) had a TST result, seven (10.6%) had a newly positive result, two had a previously positive result, and six of nine patients with positive results (66.7%) received IPT. ICF could not be assessed because of incomplete or discrepant documentation. CONCLUSIONS An in-depth evaluation of TB/HIV activities successfully identified areas of success and remaining challenges. At TB clinics, HIV testing rates are high; further scale-up of ART for persons with TB/HIV is needed. At HIV clinics, use of TST to focus IPT is a feasible and efficient strategy; improving rates of annual TST screening will allow for further expansion of IPT.
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Affiliation(s)
- Brian J Baker
- U.S. Centers for Disease Control and PreventionU.S. Centers for Disease Control and PreventionAtlantaGeorgiaUnited States of AmericaU.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.,Send correspondence to: Brian J. Baker,
| | - Brandy Peterson
- U.S. Centers for Disease Control and PreventionU.S. Centers for Disease Control and PreventionAtlantaGeorgiaUnited States of AmericaU.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
| | - Jeetendra Mohanlall
- Ministry of Health, National TB ProgrammeMinistry of Health, National TB ProgrammeGeorgetownGuyanaMinistry of Health, National TB Programme, Georgetown, Guyana.
| | - Shanti Singh
- Ministry of Health, National AIDS Programme SecretariatMinistry of Health, National AIDS Programme SecretariatGeorgetownGuyanaMinistry of Health, National AIDS Programme Secretariat, Georgetown, Guyana.
| | - Collene Hicks
- Division of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionDivision of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionGeorgetownGuyanaDivision of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Georgetown, Guyana.
| | - Ruth Jacobs
- Division of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionDivision of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionGeorgetownGuyanaDivision of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Georgetown, Guyana.
| | - Ruth Ramos
- Ministry of Health, National Care and Treatment CentreMinistry of Health, National Care and Treatment CentreGeorgetownGuyanaMinistry of Health, National Care and Treatment Centre, Georgetown, Guyana.
| | - Barbara Allen
- Division of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionDivision of Global HIV/AIDS, U.S. Centers for Disease Control and PreventionGeorgetownGuyanaDivision of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Georgetown, Guyana.
| | - Eric Pevzner
- U.S. Centers for Disease Control and PreventionU.S. Centers for Disease Control and PreventionAtlantaGeorgiaUnited States of AmericaU.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
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Zug KE, Cassiani SHDB, Pulcini J, Garcia AB, Aguirre-Boza F, Park J. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice. Rev Lat Am Enfermagem 2016; 24:e2807. [PMID: 27508923 PMCID: PMC4990050 DOI: 10.1590/1518-8345.1615.2807] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 05/22/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. METHOD a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. RESULT the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. CONCLUSION strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. OBJETIVO identificar o estado atual da regulação, educação e prática do enfermeiro de prática avançada na América Latina e no Caribe e a percepção de líderes de enfermagem na região quanto ao papel da enfermagem de prática avançada na atenção primaria à saúde em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. MÉTODO o estudo descritivo transversal utilizou um survey online com 173 líderes de enfermagem questionando suas percepções sobre o estado atual da prática de enfermagem e o potencial desenvolvimento da enfermagem de prática avançada em seus países, incluindo a definição do termo, o ambiente de trabalho, a regulação, educação, prática, cultura de enfermagem e receptividade percebida de um papel mais amplo deste profissional na atenção primaria à saúde. RESULTADO os participantes referiram estar familiarizados com o papel do enfermeiro de prática avançada, mas a maioria não sabia ou não relatou a legislação vigente para o papel da prática avançada em seus países. Os participantes relataram a necessidade de aumentar a preparação do corpo docente e promover reformas curriculares com enfase na atenção primária à saúde para formar enfermeiros de prática avançada. A grande maioria dos participantes acredita que as populações de seus países se beneficiará com o papel do enfermeiro de prática avançada na atenção primária à saúde. CONCLUSÃO forte apoio em termos de legislação e uma estrutura educacional sólida de formação contínua são fundamentais para o êxito do desenvolvimento de programas de enfermagem de prática avançada em apoio às iniciativas de Acesso Universal à Saúde e Cobertura Universal de Saúde. OBJETIVO identificar el estado actual de la regulación, educación y práctica de la enfermera de práctica avanzada en Latinoamérica y el Caribe y la percepción de los líderes de enfermería en la región hacia un rol de práctica avanzada de enfermería dentro de la atención primaria de salud para apoyar las iniciativas de Acceso Universal a la Salud y la Cobertura Universal de Salud. MÉTODO un diseño transversal descriptivo que utilizó una encuesta basada en la web a 173 líderes de enfermería acerca de sus percepciones sobre el estado de la enfermería y el desarrollo potencial de la práctica avanzada de enfermería en sus países, incluyendo definición, ambiente laboral, regulación, educación, práctica de enfermería, cultura de enfermería y la receptividad percibida a un papel más amplio en atención primaria de salud. RESULTADO los participantes estaban ampliamente familiarizados con el rol de la enfermera de práctica avanzada, pero la mayoría desconocía la legislación o reportaba no existencia actual de legislación para el rol de práctica avanzada en sus países. Los participantes reportaron la necesidad de aumentar la preparación docente y reformas curriculares para apoyar programas de atención primaria de salud para capacitar las enfermeras de práctica avanzada. La gran mayoría de los participantes creían que las poblaciones de sus países se podrían beneficiar de un rol de práctica avanzada de enfermería en atención primaria de salud. CONCLUSIÓN un fuerte apoyo legislativo y un marco educacional sólido que continúen informándose entre sí, son críticos para el desarrollo exitoso de programas de práctica avanzada y de nurse practitioners para apoyar las iniciativas de Acceso Universal a la Salud y Cobertura Universal de Salud.
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Affiliation(s)
- Keri Elizabeth Zug
- Master's Student, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Joyce Pulcini
- Professor, School of Nursing, George Washington University, Washington DC, USA
| | | | | | - Jeongyoung Park
- Assistant Professor, School of Nursing, George Washington University, Washington DC, USA
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6
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Wright M, Adair L, James C, Amuleru-Marshall O, Peltzer K, Pengpid S, Samuels TA. The association of nutrition behaviors and physical activity with general and central obesity in Caribbean undergraduate students. Rev Panam Salud Publica 2015; 38:278-285. [PMID: 26758218 PMCID: PMC6634991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 05/26/2015] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To quantify the prevalence of obesity and obesity-related factors in a crosssectional, observational study of Caribbean students using the results of three recent surveys of health behavior among undergraduates in Barbados, Grenada, and Jamaica. METHODS A total of1 578 Caribbean undergraduate students from Barbados, Grenada, and Jamaica (ages 18-30 years) completed questionnaires and had physical measurements recorded. Multivariable logistic regression was used to estimate odds ratios (ORs) for the association of nutrition behaviors with prevalence of obesity (body mass index > 30 kg/m² ); elevated waist-to-height ratio (W/ht) (> 0.50); and high waist circumference (WC) (> 88 cm in females, > 102 cm in males). Models were adjusted for age, year in university, socioeconomic status, and sex. RESULTS There was a higher prevalence of obesity (13% versus 10%), high WC (21% versus 7%), and high W/ht (35% versus 25%) in females relative to males. Compared to females, males had reduced odds of obesity (OR 0.46), high WC (OR 0.22), and high W/ht (OR 0.61) (P < 0.05 for all). Both females (46%) and males (24%) reported high levels of physical inactivity. Fruit and vegetable consumption was low (approximately two servings per day). Many students reported avoiding fatty foods (40%); this behavior was associated with high W/ht (OR 1.68), obesity (OR 1.90), and high WC (OR 1.82) (P < 0.05 for all). Irregular breakfast consumption, age, and year of study were also positively associated with obesity. Physical activity was not significantly associated with any obesity measure. CONCLUSIONS There was a low prevalence of healthy behaviors and a high prevalence of obesity in this sample of Caribbean young adults.
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Affiliation(s)
- Melecia Wright
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America,
| | - Linda Adair
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America,
| | - Caryl James
- University of the West Indies, Kingston, Jamaica
| | | | - Karl Peltzer
- Human Sciences Research Council, Pretoria, South Africa
| | - Supa Pengpid
- Human Sciences Research Council, Pretoria, South Africa
| | - T Alafia Samuels
- Faculty of Medical Sciences, University of the West Indies, St. Michael, Barbados
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Acevedo P, Jorge JC, Cruz-Sánchez A, Amy E, Barreto-Estrada JL. A ten-year assessment of anabolic steroid misuse among competitive athletes in Puerto Rico. W INDIAN MED J 2011; 60:531-535. [PMID: 22519228 PMCID: PMC3436118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Little is known about anabolic androgenic steroids (AAS) misuse in the Caribbean region in spite of increased popularity among athletes and adolescents. The present study examines the usage of AAS among competitive athletes in Puerto Rico. METHODS Doping test results of competitive athletes obtained by random sampling out of competition during the 2000-2009 period were analysed. Doping tests were executed by the Centre for Sports, Health and Exercise Sciences (Albergue Olímpico, Salinas, Puerto Rico). A total of 550 athletes were monitored during 2000-2009. Information was collected with regard to competitive sport, gender and AAS compounds whenever a positive test result was encountered. RESULTS From the total sample of monitored cases during the past decade, 5.4% showed adverse analytical findings. Anabolic androgenic steroids misuse was detected among male (62%) and female (38%) athletes. Weightlifting showed the greatest percentage of positive AAS doping test results (70% of total cases) and stanozolol was the most commonly misused exogenous androgen (60% of abused AAS whether alone or as part of a cocktail). Testosterone was the most common endogenous misused steroid (10% of misused compounds). CONCLUSION In Puerto Rico, AAS misuse was detected across competitive sports for both genders. Although AAS misuse among Puerto Rican athletes shares some features that are consistent with the international sports community, it is imperative to address AAS misuse in the Caribbean region.
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Affiliation(s)
- P Acevedo
- School of Medicine, Department of Anatomy and Neurobiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00936
| | - JC Jorge
- School of Medicine, Department of Anatomy and Neurobiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00936
| | - A Cruz-Sánchez
- School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00936
| | - E Amy
- School of Medicine, Department of Physical Medicine, Rehabilitation and Sports Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00936
| | - JL Barreto-Estrada
- School of Medicine, Department of Anatomy and Neurobiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico 00936
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Razzouk D, Gallo C, Olifson S, Zorzetto R, Fiestas F, Poletti G, Mazzotti G, Levav I, Mari JJ. Challenges to reduce the '10/90 gap': mental health research in Latin American and Caribbean countries. Acta Psychiatr Scand 2008; 118:490-8. [PMID: 18759812 PMCID: PMC2659385 DOI: 10.1111/j.1600-0447.2008.01242.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To analyze the status of mental health research in 30 Latin American and Caribbean countries (LAC). METHOD Medline and PsycInfo databases were searched to identify the LAC authors. Their publications were classified according to the topic, type of research and target population studied. Scientific indicators of these countries were assessed in other two different databases: Essential Scientific Information and Atlas of Science Project, both from Institute for Scientific Information. RESULTS Indexed-publications were concentrated in six countries: Argentina, Brazil, Chile, Colombia, Mexico and Venezuela. Most studies dealt with the burdensome mental disorders but neglected important topics such as violence and other mental health priorities. CONCLUSION Mental health research is mostly concentrated in a few LAC countries, but these countries would contribute to reduce the research gap, if they provide research training to their neighbors and engage in bi- or multi-lateral research collaboration on common region priorities.
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Affiliation(s)
- D Razzouk
- Department of Psychiatry, Federal University of Sao Paulo, São Paulo, Brazil.
| | - C Gallo
- Laboratory of Research and Development, Faculty of Sciences and Philosophy, University Peruana Cayetano HerediaLima, Peru
| | - S Olifson
- Research and Programmes, Global Forum for Health ResearchGeneva, Switzerland
| | - R Zorzetto
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP)São Paulo, Brazil
| | - F Fiestas
- Laboratory of Research and Development, Faculty of Sciences and Philosophy, University Peruana Cayetano HerediaLima, Peru
| | - G Poletti
- Laboratory of Research and Development, Faculty of Sciences and Philosophy, University Peruana Cayetano HerediaLima, Peru
| | - G Mazzotti
- Laboratory of Research and Development, Faculty of Sciences and Philosophy, University Peruana Cayetano HerediaLima, Peru
| | - I Levav
- Mental Health Services, Ministry of HealthJerusalem, Israel
| | - J J Mari
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP)São Paulo, Brazil
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Abstract
BACKGROUND: As developing countries shift to increasing prevalence of cardiovascular risk factors and diseases (CVD), prevention efforts, both primary and secondary, become a public health priority. Designing effective methods requires a clear understanding of local beliefs and practices regarding health risks and behaviors. METHODS: A mixed gender and age team deployed a Rapid Assessment Protocol (participant observation; interviews) over three days. Interviews from 25 residents of Carriacou, Grenada included leaders and community members representing a range of demographic characteristics (gender, age, employment). RESULTS: Residents expressed general uncertainty about their actual health. While acknowledging that certain conditions (e.g. diabetes, hypertension) were prevalent, heredity was viewed as being more strongly associated with CVD. Not being able to work or carry out one's daily activities often drove health care seeking behavior (evaluation, care or initiating lifestyle changes). Health improvement activities when practiced were fragmented, not an overall lifestyle change. Physical activity was implicitly valued but not universally practiced; it declined with age and increasing work and other commitments. CONCLUSIONS: While public health programs benefit from understanding community attitudes and beliefs, research to inform program development is often not undertaken or if undertaken not effectively utilized to make needed program modifications. Key to our conclusions was their perspective on health as illness oriented and reactive, strongly associated with heredity rather than preventive and associated with behavior change. A preventive focus informed by local practices is fundamental to designing effective and sustainable primary and secondary prevention programs and particularly useful in developing countries.
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Affiliation(s)
- Ann M Dozier
- Department of Community and Preventive Medicine Box 278969 University of Rochester Rochester, New York 14627 Ph: 585.758-7812 Fx: 585-424-1469
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