Browsing by Author "Nunes, Paula"
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Item Health Risk Behaviours Among Adolescents in the English-speaking Caribbean: a Review(2009) Maharaj, Rohan G.; Nunes, Paula; Renwick, ShaminBackground: The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean. Methods: Searching of online databases and the World Wide Web as well as hand searching of the West Indian Medical Journal were conducted. Papers on research done on adolescents aged 10 . 19 years old and published during the period 1980 . 2005 were included. Results: Ninety-five relevant papers were located. Five papers were published in the 1980s, 47 in the 1990s, and from 2000.2005, 43 papers. Health risk behaviours and outcomes were divided into seven themes. Prevalence data obtained for these, included lifetime prevalence of substance use: cigarettes-24% and marijuana-17%; high risk sexual behaviour: initiation of sexual activity . 10 years old-19% and those having more than six partners-19%; teenage pregnancy: teens account for 15.20% of all pregnancies and one-fifth of these teens were in their second pregnancy; Sexually-Transmitted Infections (STIs): population prevalence of gonorrhoea and/or chlamydia in 18.21 year-olds was 26%; mental health: severe depression in the adolescent age group was 9%, and attempted suicide-12%; violence and juvenile delinquency: carrying a weapon to school in the last 30 days-10% and almost always wanting to kill or injure someone-5%; eating disorders and obesity: overweight-11%, and obesity-7%. Many of the risk behaviours in adolescents were shown to be related to the adolescent's family of origin, home environment and parent-child relationships. Also, the protective effects of family and school connectedness as well as increased religiosity noted in studies from the United States were also applicable in the Caribbean. Conclusion: There is a substantial body of literature on Caribbean adolescents documenting prevalence and correlates of health risk behaviours. Future research should emphasize the designing and testing of interventions to alleviate this burden.Item Is the Advanced Pediatric Life Support formula used to calculate weight-for-age applicable to a Trinidadian population?(2012-08-02) Ali, Khalid; Sammy, Ian; Nunes, PaulaAbstract Background In paediatric emergency medicine, estimation of weight in ill children can be performed in a variety of ways. Calculation using the and#8216;APLSand#8217; formula (weightand#8201;=and#8201;[ageand#8201;+and#8201;4] and#215; 2) is one very common method. Studies on its validity in developed countries suggest that it tends to under-estimate the weight of children, potentially leading to errors in drug and fluid administration. The formula is not validated in Trinidad and Tobago, where it is routinely used to calculate weight in paediatric resuscitation. Methods Over a six-week period in January 2009, all children one to five years old presenting to the Emergency Department were weighed. Their measured weights were compared to their estimated weights as calculated using the APLS formula, the Luscombe and Owens formula and a and#8220;best fitand#8221; formula derived (then simplified) from linear regression analysis of the measured weights. Results The APLS formula underestimated weight in all age groups with a mean difference of and#8722;1.4and#8201;kg (95% limits of agreement 5.0 to and#8722;7.8). The Luscombe and Owens formula was more accurate in predicting weight than the APLS formula, with a mean difference of and#8722;0.4and#8201;kg (95% limits of agreement 6.9 to and#8722;6.1%). Using linear regression analysis, and simplifying the derived equation, the best formula to describe weight and age was (weightand#8201;=and#8201;[2.5 x age]and#8201;+and#8201;8). The percentage of children whose actual weight fell within 10% of the calculated weights using any of the three formulae was not significantly different. Conclusions The APLS formula slightly underestimates the weights of children in Trinidad, although this is less than in similar studies in developed countries. Both the Luscombe and Owens formula and the formula derived from the results of this study give a better estimate of the measured weight of children in Trinidad. However, the accuracy and precision of all three formulae were not significantly different from each other. It is recommended that the APLS formula should continue to be used to estimate the weight of children in resuscitation situations in Trinidad, as it is well known, easy to calculate and widely taught in this setting.Item The National Alcohol Survey of Households in Trinidad and Tobago (NASHTT): willingness to support changes in policy, laws and regulations(2018-10-25) Maharaj, Rohan G; Babwah, Terence; Motilal, M. S; Nunes, Paula; Brathwaite, Rachel; Legall, George; Reid, Sandra DAbstract Background Over 60% of households (HHs) in Trinidad and Tobago (T&T) consume alcohol. These HHs were more likely to report illnesses, relationship problems, and behavioral problems with children. This study set out to determine what proportion of HHs were willing to support changes in specific policies, laws and regulations in a national alcohol campaign. Methods A cross-sectional convenience sample of HHs were surveyed from a random sample of enumeration districts (ED) in T&T. An interviewer-applied, field pre-tested de novo questionnaire had 5 domains and was developed over 1 1/2 years after an extensive literature review and consultation. Many of the WHO ‘best buys’ recommendations were included. Results One thousand six hundred ninety-five HHs (from 53 ED) responded from a total of 1837 HHs approached (response rate 92%). In a national campaign the following proportions of HHs would support: setting the legal age for drinking at 21 years (82.4%); restricting or banning alcohol advertising on TV and other media (73.1% and 54.4% respectively); banning all alcohol advertising at sports and cultural events (64.8%); banning radio stations playing songs with reference to alcohol use (71.3%); holding sellers of alcohol responsible for the amount of alcohol sold (79.5%); advocating that proof of age to be shown by persons buying alcohol (87.4%); placing more prominent warning labels on products displaying alcohol content (87.2%); placing more prominent warning labels on products showing harmful effects (88.5%); increasing taxes on alcohol sales (87.7%). Less than 50% of HH supported restrictions in density of outlets and reduction in opening times for alcohol outlets. Conclusions Many HHs in T&T are willing to support changes in policies around alcohol, including many of the policies shown by the WHO to be effective in reducing the harmful consumption of alcohol.