S. Howell, K. Marshall, M. Reid, N. McFarlane‐Anderson, C. McKenzie
Objective: To explore potential associations between four biallelic variants within three genes that code for enzymes involved in either the transmethylation (methylene tetrahydrofolate reductase (MTHFR), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR)) or trans-sulphuration (cystathionine beta-synthase (CBS)) metabolic pathways, and clinically relevant phenotypic measures in sickle cell anaemia [homozygous haemoglobin SS] (HbSS). Methods: A total of 371 participants with HbSS disease were recruited from the Sickle Cell Clinic of the Sickle Cell Unit at The University of the West Indies, Mona, Jamaica. Genotypes at four sites (MTHFR C677T, MTHFR A1298C, MTR A2756G and CBS 844ins68) within the three genes were determined using polymerase chain reaction-based assays. Results: Univariate regression analyses showed statistically significant associations between MTHFR C677T and red blood cell (RBC) count (p = 0.019) and between MTHFR C677T and mean corpuscular volume (p = 0.015). Multivariable regression analyses showed statistically significant associations between MTHFR C677T and packed cell volume values (p = 0.019), between MTHFR C677T and RBC count (p = 0.013), and between MTHFR A1298C and mean corpuscular haemoglobin concentration (p = 0.026). Conclusion: This exploratory cross-sectional study has generated novel and informative genotype-phenotype estimates of association, but larger studies are needed to determine whether the specific variants within these genes underlying the transmethylation and trans-sulphuration pathways are related to inter-individual phenotypic variability in HbSS.
{"title":"A Cross-sectional Clinic-based Study Exploring whether Variants within Genes Coding for Enzymes of the Transmethylation and Trans-sulphuration Pathways Are Associated with Inter-individual Phenotypic Variation in Sickle Cell Anaemia in Jamaica","authors":"S. Howell, K. Marshall, M. Reid, N. McFarlane‐Anderson, C. McKenzie","doi":"10.7727/WIMJ.2017.205","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.205","url":null,"abstract":"Objective: To explore potential associations between four biallelic variants within three genes that code for enzymes involved in either the transmethylation (methylene tetrahydrofolate reductase (MTHFR), 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR)) or trans-sulphuration (cystathionine beta-synthase (CBS)) metabolic pathways, and clinically relevant phenotypic measures in sickle cell anaemia [homozygous haemoglobin SS] (HbSS). Methods: A total of 371 participants with HbSS disease were recruited from the Sickle Cell Clinic of the Sickle Cell Unit at The University of the West Indies, Mona, Jamaica. Genotypes at four sites (MTHFR C677T, MTHFR A1298C, MTR A2756G and CBS 844ins68) within the three genes were determined using polymerase chain reaction-based assays. Results: Univariate regression analyses showed statistically significant associations between MTHFR C677T and red blood cell (RBC) count (p = 0.019) and between MTHFR C677T and mean corpuscular volume (p = 0.015). Multivariable regression analyses showed statistically significant associations between MTHFR C677T and packed cell volume values (p = 0.019), between MTHFR C677T and RBC count (p = 0.013), and between MTHFR A1298C and mean corpuscular haemoglobin concentration (p = 0.026). Conclusion: This exploratory cross-sectional study has generated novel and informative genotype-phenotype estimates of association, but larger studies are needed to determine whether the specific variants within these genes underlying the transmethylation and trans-sulphuration pathways are related to inter-individual phenotypic variability in HbSS.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45314900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the associations of frequency, quantity and duration of marijuana use with sperm parameters and reproductive histories of male non-smokers and chronic marijuana users. Methods: Semen samples and marijuana consumption histories were obtained from 94 men aged 23–72 years who attended a university-based private fertility management unit for infertility investigations between February and September 2014. Routine semen analyses were performed, and the associations of frequency and duration of marijuana use with sperm parameters and reproductive history were assessed. Results: Lower motility was associated with higher quantities (Spearman’s correlation coefficient, rs = -0.226; p = 0.045) and frequency (rs = -0.234, p = 0.047) of marijuana smoked at a given time. However, duration of marijuana use showed no clear pattern of association with sperm quality. No significant associations were found between marijuana use and reproductive history. Conclusion: Preliminary findings, using a small sample of subfertile men, suggested that sperm motility may be impacted by the quantity and frequency of marijuana use. Screening for excessive use of marijuana and counselling on the potential impact of the drug should be routinely considered for men being treated for infertility.
{"title":"Associations between Marijuana Use and Sperm Quality in Jamaican Men: Implications for the Subfertile Male","authors":"K. Carroll, A. Pottinger, Jackson","doi":"10.7727/wimj.2017.189","DOIUrl":"https://doi.org/10.7727/wimj.2017.189","url":null,"abstract":"Objective: To evaluate the associations of frequency, quantity and duration of marijuana use with sperm parameters and reproductive histories of male non-smokers and chronic marijuana users. Methods: Semen samples and marijuana consumption histories were obtained from 94 men aged 23–72 years who attended a university-based private fertility management unit for infertility investigations between February and September 2014. Routine semen analyses were performed, and the associations of frequency and duration of marijuana use with sperm parameters and reproductive history were assessed. Results: Lower motility was associated with higher quantities (Spearman’s correlation coefficient, rs = -0.226; p = 0.045) and frequency (rs = -0.234, p = 0.047) of marijuana smoked at a given time. However, duration of marijuana use showed no clear pattern of association with sperm quality. No significant associations were found between marijuana use and reproductive history. Conclusion: Preliminary findings, using a small sample of subfertile men, suggested that sperm motility may be impacted by the quantity and frequency of marijuana use. Screening for excessive use of marijuana and counselling on the potential impact of the drug should be routinely considered for men being treated for infertility.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45566365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Bernard, W. Abel, P. Whitehorne-Smith, Gabrielle Mitchell, E. Thompson, K. Lalwani, C. Sewell, D. Oshi
The aim of this study was to determine whether perception of risk and accessibility of cannabis predicted the age of initiation of cannabis use among Jamaican secondary school students. Data from a nationally representative sample were analysed. Descriptive statistical analysis was done while binary logistic regression was used to compute point estimates and confidence intervals (CIs). The median age of initiation was 13 years. Gender was a predictor of age of initiation, with females having 39% less risk of initiating cannabis use at the age of 13 years or younger before adjusting for covariates (crude odds ratio [COR]: 0.61; 95% CI: 0.48, 0.77), which increased to 42% reduced risk of initiating cannabis use at the age of 13 years or younger after adjusting for covariates (adjusted OR [AOR]: 0.58; 95% CI: 0.39, 0.85). There was a significant inverse association between grade level in school and age of initiation of cannabis use, with 11th grade students having a significantly reduced risk of commencing cannabis use at the age of 13 years or younger (COR: 0.41; 95% CI: 0.23, 0.70; AOR: 0.41; 95% CI: 0.23, 0.72). Participants who perceived cannabis use as moderately harmful were 67% less likely to initiate cannabis use at the age of 13 years or younger compared to participants who thought it was not harmful (AOR: 0.33; 95% CI: 0.12, 0.88). Perceptions of access to cannabis did not predict age of initiation of cannabis use. Being female, being in the 11th grade and the perception that cannabis use was moderately harmful significantly reduced the risk of initiating cannabis use at the age of 13 years or younger.
{"title":"Cannabis Use among Secondary School Students in Jamaica: Factors Associated with Age of Initiation","authors":"T. Bernard, W. Abel, P. Whitehorne-Smith, Gabrielle Mitchell, E. Thompson, K. Lalwani, C. Sewell, D. Oshi","doi":"10.7727/WIMJ.2017.214","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.214","url":null,"abstract":"The aim of this study was to determine whether perception of risk and accessibility of cannabis predicted the age of initiation of cannabis use among Jamaican secondary school students. Data from a nationally representative sample were analysed. Descriptive statistical analysis was done while binary logistic regression was used to compute point estimates and confidence intervals (CIs). The median age of initiation was 13 years. Gender was a predictor of age of initiation, with females having 39% less risk of initiating cannabis use at the age of 13 years or younger before adjusting for covariates (crude odds ratio [COR]: 0.61; 95% CI: 0.48, 0.77), which increased to 42% reduced risk of initiating cannabis use at the age of 13 years or younger after adjusting for covariates (adjusted OR [AOR]: 0.58; 95% CI: 0.39, 0.85). There was a significant inverse association between grade level in school and age of initiation of cannabis use, with 11th grade students having a significantly reduced risk of commencing cannabis use at the age of 13 years or younger (COR: 0.41; 95% CI: 0.23, 0.70; AOR: 0.41; 95% CI: 0.23, 0.72). Participants who perceived cannabis use as moderately harmful were 67% less likely to initiate cannabis use at the age of 13 years or younger compared to participants who thought it was not harmful (AOR: 0.33; 95% CI: 0.12, 0.88). Perceptions of access to cannabis did not predict age of initiation of cannabis use. Being female, being in the 11th grade and the perception that cannabis use was moderately harmful significantly reduced the risk of initiating cannabis use at the age of 13 years or younger.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71216683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. Abel, S. Longman-Mills, Jeannett Martin, D. Oshi, P. Whitehorne-Smith
Objective: Mental illness is a major cause of morbidity and, globally, has a high lifetime risk. Mental health literacy is known to improve symptom recognition, care-seeking and treatment outcomes. This study therefore sought to assess the knowledge and beliefs of Jamaicans regarding the definition, aetiology, symptomatology, treatment and prevention of mental illness. Method: A nationally representative, randomly selected sample of 1224 respondents completed a 50-item questionnaire in a cross-sectional survey in Jamaica. Results: The highest proportion of respondents (31.9%) defined mental health as ‘a mad person/mentally disturbed’ while 57.4% defined mental illness as ‘mad/mentally disturbed/not in the right mind’. Though the majority of the respondents believed that mental illness could be identified, perception of identification features varied: worrying (68.6%), smoking ganja (62.3%) and studying too much (47.9%). Level of education and age were significantly associated with perceptions on ways to identify mental illness. Gender and educational level were significantly associated with perceptions on treatment and prevention of mental illness. Conclusion: There was limited knowledge of the definition, aetiology, symptomatology, treatment and prevention of mental illness. Low mental health literacy was associated with having little or no formal education, being a male and being in the younger age group (15–29 years).
{"title":"Does Ganja Cause Mental Illness? Perspectives from a Population-based Assessment of Mental Health Literacy in Jamaica","authors":"W. Abel, S. Longman-Mills, Jeannett Martin, D. Oshi, P. Whitehorne-Smith","doi":"10.7727/wimj.2017.209","DOIUrl":"https://doi.org/10.7727/wimj.2017.209","url":null,"abstract":"Objective: Mental illness is a major cause of morbidity and, globally, has a high lifetime risk. Mental health literacy is known to improve symptom recognition, care-seeking and treatment outcomes. This study therefore sought to assess the knowledge and beliefs of Jamaicans regarding the definition, aetiology, symptomatology, treatment and prevention of mental illness. Method: A nationally representative, randomly selected sample of 1224 respondents completed a 50-item questionnaire in a cross-sectional survey in Jamaica. Results: The highest proportion of respondents (31.9%) defined mental health as ‘a mad person/mentally disturbed’ while 57.4% defined mental illness as ‘mad/mentally disturbed/not in the right mind’. Though the majority of the respondents believed that mental illness could be identified, perception of identification features varied: worrying (68.6%), smoking ganja (62.3%) and studying too much (47.9%). Level of education and age were significantly associated with perceptions on ways to identify mental illness. Gender and educational level were significantly associated with perceptions on treatment and prevention of mental illness. Conclusion: There was limited knowledge of the definition, aetiology, symptomatology, treatment and prevention of mental illness. Low mental health literacy was associated with having little or no formal education, being a male and being in the younger age group (15–29 years).","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47195791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Irons-Morgan, W. Abel, S. Longman-Mills, James Martin, C. Mitchell, P. Whitehorne-Smith
{"title":"Psychological Autopsy of Cases of Suicide for the Year 2012","authors":"M. Irons-Morgan, W. Abel, S. Longman-Mills, James Martin, C. Mitchell, P. Whitehorne-Smith","doi":"10.7727/wimj.2017.190","DOIUrl":"https://doi.org/10.7727/wimj.2017.190","url":null,"abstract":"","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46508765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This review focussed on the role of the endocannabinoid system in relation to pain transmission and modulation. Various facets of both naturally occurring and synthetic cannabinoids (CBs) were explored in an effort to ascertain their suitability in the treatment and management of pain. Methods: The endocannabinoid system and the physiology of CBs were reviewed in isolation and in relation to their hypothesized role in treating pain. Results: Cannabinoids have a more significant effect in instances of chronic pain than acute pain. Inhibitory mechanisms may be more effective than direct activation of the cannabinoid receptors. Many clinical trials of both genuine and synthetic cannabis-mediated analgesia have provided negative or equivocal results. Conclusion: Medications prepared with cannabinoid receptor agonists or with drugs that enhance endocannabinoid function (by either increasing release or diminishing reuptake of endocannabinoids) may afford the novel therapeutic approaches demanded by disorders in which pain is a prominent symptom.
{"title":"The Cannabinoids as Therapeutic Agents in the Management of Pain","authors":"C. McGaw","doi":"10.7727/WIMJ.2017.192","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.192","url":null,"abstract":"Objective: This review focussed on the role of the endocannabinoid system in relation to pain transmission and modulation. Various facets of both naturally occurring and synthetic cannabinoids (CBs) were explored in an effort to ascertain their suitability in the treatment and management of pain. Methods: The endocannabinoid system and the physiology of CBs were reviewed in isolation and in relation to their hypothesized role in treating pain. Results: Cannabinoids have a more significant effect in instances of chronic pain than acute pain. Inhibitory mechanisms may be more effective than direct activation of the cannabinoid receptors. Many clinical trials of both genuine and synthetic cannabis-mediated analgesia have provided negative or equivocal results. Conclusion: Medications prepared with cannabinoid receptor agonists or with drugs that enhance endocannabinoid function (by either increasing release or diminishing reuptake of endocannabinoids) may afford the novel therapeutic approaches demanded by disorders in which pain is a prominent symptom.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48300456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the addictive potential of cannabis by investigating the motivational responses to low doses of delta-9-tetrahydrocannabinol (∆9-THC) and a marijuana tea extract (MTE), and to determine if the length of the conditioning period in the conditioned place preference (CPP) paradigm influences reward or aversion to these cannabinoid preparations. Methods: Thirty-eight Sprague-Dawley rats were taken through a biased CPP paradigm utilizing an eight-day schedule. The pre-conditioning phase consisted of three trials of 15 minutes each, and the conditioning phase lasted either 40 or 18 minutes in the drug-paired, ‘nonpreferred’ white chamber or the vehicle-paired, ‘preferred’ black chamber. Spontaneous motor activity (SMA) was used to determine the 18-minute conditioning period, dosage of a crude MTE and the oil-based vehicle for ∆9-THC (coconut oil), which did not alter the SMA of the rats. Differences in the mean times spent in the ‘non-preferred’ white chamber during the preconditioning and post-conditioning periods were compared using paired t-test. Results: Significant place aversion (p < 0.0001) to the MTE occurred at the 40-minute conditioning period, but not at the 18-minute period. Also, significant CPP reward (p < 0.01) to 0.05 mg/kg ∆9-THC occurred with the reduced 18-minute conditioning period, while a non-significant increase in post-conditioning time at the higher dose of 2.0 mg/kg ∆9-THC was obtained. Conclusion: Drug-seeking, motivational reward to 0.05 mg/kg ∆9-THC confirmed the addictive potential of ∆9-THC. However, the duration of the conditioning period in the CPP design was a determinant of the outcome to CPP-reward or -aversion to marijuana.
{"title":"Dosage and Conditioning Period Determine Reward or Aversion to Cannabis-induced Conditioned Place Preference in Sprague-Dawley Rats","authors":"L. Young, Kp Chin-Quee","doi":"10.7727/WIMJ.2017.185","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.185","url":null,"abstract":"Objective: To assess the addictive potential of cannabis by investigating the motivational responses to low doses of delta-9-tetrahydrocannabinol (∆9-THC) and a marijuana tea extract (MTE), and to determine if the length of the conditioning period in the conditioned place preference (CPP) paradigm influences reward or aversion to these cannabinoid preparations. Methods: Thirty-eight Sprague-Dawley rats were taken through a biased CPP paradigm utilizing an eight-day schedule. The pre-conditioning phase consisted of three trials of 15 minutes each, and the conditioning phase lasted either 40 or 18 minutes in the drug-paired, ‘nonpreferred’ white chamber or the vehicle-paired, ‘preferred’ black chamber. Spontaneous motor activity (SMA) was used to determine the 18-minute conditioning period, dosage of a crude MTE and the oil-based vehicle for ∆9-THC (coconut oil), which did not alter the SMA of the rats. Differences in the mean times spent in the ‘non-preferred’ white chamber during the preconditioning and post-conditioning periods were compared using paired t-test. Results: Significant place aversion (p < 0.0001) to the MTE occurred at the 40-minute conditioning period, but not at the 18-minute period. Also, significant CPP reward (p < 0.01) to 0.05 mg/kg ∆9-THC occurred with the reduced 18-minute conditioning period, while a non-significant increase in post-conditioning time at the higher dose of 2.0 mg/kg ∆9-THC was obtained. Conclusion: Drug-seeking, motivational reward to 0.05 mg/kg ∆9-THC confirmed the addictive potential of ∆9-THC. However, the duration of the conditioning period in the CPP design was a determinant of the outcome to CPP-reward or -aversion to marijuana.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46656094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Morrison, D. Cornwall, Wendy Madden, P. Johnson, M. Didier, M. Reid
Objective: The prevalence of asymptomatic bacteriuria (ASB) in sickle cell disease (SCD) in Jamaica is 5.3%. This study sought to determine the association between ASB and anatomical urological abnormalities and symptomatic urinary tract infections (UTIs). Methods: A matched case-controlled study of 11 patients with a history of ASB from the Jamaican Sickle Cell Cohort and 11 controls who did not have a history of ASB or recurrent UTIs but who had SCD was conducted. Midstream urine collected aseptically was obtained for urinalysis and culture and sensitivity analysis. Serum creatinine was measured. Voiding cystourethrogram (VCUG) and kidney-ureter-bladder ultrasound were done. History of UTIs was recorded in all cases. Results: The mean ± sd age of the group (cases and controls) was 34.2 ± 7.2 years. All VCUGs were normal. There was no difference in mean cortical thickness or renal scarring between cases and controls. All serum creatinine values were normal: cases (mean ± sd: 55.9 ± 15.3; min-max: 32–90 μmol/L) and controls (mean ± sd: 59.6 ± 18.5; min-max: 41–95 μmol/L). There was no difference in symptomatic UTIs between cases and controls. Conclusion: There was no association between anatomical urinary tract abnormalities and ASB in patients with SCD. Asymptomatic bacteriuria in SCD was not associated with increased numbers of symptomatic UTIs.
{"title":"Radiological Abnormalities and Asymptomatic Bacteriuria in Patients with Sickle Cell Disease","authors":"B. Morrison, D. Cornwall, Wendy Madden, P. Johnson, M. Didier, M. Reid","doi":"10.7727/WIMJ.2017.203","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.203","url":null,"abstract":"Objective: The prevalence of asymptomatic bacteriuria (ASB) in sickle cell disease (SCD) in Jamaica is 5.3%. This study sought to determine the association between ASB and anatomical urological abnormalities and symptomatic urinary tract infections (UTIs). Methods: A matched case-controlled study of 11 patients with a history of ASB from the Jamaican Sickle Cell Cohort and 11 controls who did not have a history of ASB or recurrent UTIs but who had SCD was conducted. Midstream urine collected aseptically was obtained for urinalysis and culture and sensitivity analysis. Serum creatinine was measured. Voiding cystourethrogram (VCUG) and kidney-ureter-bladder ultrasound were done. History of UTIs was recorded in all cases. Results: The mean ± sd age of the group (cases and controls) was 34.2 ± 7.2 years. All VCUGs were normal. There was no difference in mean cortical thickness or renal scarring between cases and controls. All serum creatinine values were normal: cases (mean ± sd: 55.9 ± 15.3; min-max: 32–90 μmol/L) and controls (mean ± sd: 59.6 ± 18.5; min-max: 41–95 μmol/L). There was no difference in symptomatic UTIs between cases and controls. Conclusion: There was no association between anatomical urinary tract abnormalities and ASB in patients with SCD. Asymptomatic bacteriuria in SCD was not associated with increased numbers of symptomatic UTIs.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42413144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This exploratory qualitative study sought to investigate the question of ‘how do marijuana smokers at a tertiary institution perceive their susceptibility to mental illness?’. Methods: The study utilized an instrumental case study design. Convenience and snowball sampling techniques were employed to garner participants. Inclusion criteria were that the participants had to be enrolled at a tertiary institution and had smoked at least an average of one spliff of marijuana per week for at least one year. Data collection comprised 12 in-depth interviews with the participants (six male and six female), direct observation, and content analysis of Jamaica’s amended Dangerous Drugs Act of 2015. Results: Emergent were themes of personal experience, social environment and low-risk perception for mental illness. Conclusion: Risk perception for mental illness was low. Participants perceived marijuana use as a viable coping strategy and demonstrated limited understanding of the negative effects of smoking marijuana.
{"title":"Perceived Susceptibility to Mental Disorders among Marijuana Smokers Attending a Tertiary Institution","authors":"N. Albarus, P. Whitehorne-Smith, W. Abel","doi":"10.7727/WIMJ.2017.193","DOIUrl":"https://doi.org/10.7727/WIMJ.2017.193","url":null,"abstract":"Objective: This exploratory qualitative study sought to investigate the question of ‘how do marijuana smokers at a tertiary institution perceive their susceptibility to mental illness?’. Methods: The study utilized an instrumental case study design. Convenience and snowball sampling techniques were employed to garner participants. Inclusion criteria were that the participants had to be enrolled at a tertiary institution and had smoked at least an average of one spliff of marijuana per week for at least one year. Data collection comprised 12 in-depth interviews with the participants (six male and six female), direct observation, and content analysis of Jamaica’s amended Dangerous Drugs Act of 2015. Results: Emergent were themes of personal experience, social environment and low-risk perception for mental illness. Conclusion: Risk perception for mental illness was low. Participants perceived marijuana use as a viable coping strategy and demonstrated limited understanding of the negative effects of smoking marijuana.","PeriodicalId":49366,"journal":{"name":"West Indian Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43544160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Oshi, W. Abel, Tana F. Ricketts-Roomes, C. Agu, Sarah N. Oshi, Joy Harrison, K. Smith, U. Atkinson, P. Clarke, A. Bailey, P. Whitehorne-Smith
Objective: Cigarettes, alcohol, cannabis, inhalants and cocaine are the most commonly used substances among high school students in Jamaica. However, there is limited evidence on their co-use and whether the use of one drug predicts the use of the others (multiple substance use). This study aimed to determine whether cannabis use predicts the co-use of the other substances. Methods: We analysed data from the National Secondary School Survey 2013, Jamaica, using inferential statistics to determine associations. Results: Lifetime cannabis use was significantly associated with lifetime cigarette use for males (X2 = 282.72, p = 0.000) and females (X2 = 434.32, p = 0.000). Similarly, it was significantly associated with: (a) lifetime use of alcohol for males (X2 = 88.62, p = 0.000) and females (X2 = 99.48, p = 0.000); (b) lifetime use of inhalants for males (X2 = 13.28, p = 0.00) and females (X2 = 49.56, p = 0.00); and (c) lifetime cocaine use for males (X2 = 9.78, p = 0.00) and females (X2 = 64.54, p = 0.00). Past-month (recent) use of cannabis was significantly associated with past-month use of cigarettes and alcohol, but not inhalants, for males and females. Logistic regression results showed that lifetime cannabis use was a risk factor for lifetime use of cigarettes (adjusted odds ratio [AOR]: 11.38; 95% confidence interval [CI]: 9.02, 14.37) and alcohol (AOR: 5.84; 95% CI: 4.11, 8.30), but a strong protective factor against lifetime use of inhalants and cocaine. Past-month use of cannabis was a strong protective factor against pastmonth use of cigarettes and alcohol. Conclusion: Lifetime cannabis use was significantly associated with multiple substance use and was shown to be a risk factor for lifetime use of cigarettes and of alcohol. However, adolescents who reported recent (past-month) use of cannabis were less likely to report recent use of alcohol and cigarettes. These findings suggest the need for research to further explore the role cannabis plays in multiple drug use and offer more concrete explanations for its role.
目的:香烟、酒精、大麻、吸入剂和可卡因是牙买加高中生中最常用的物质。然而，关于它们的共同使用以及使用一种药物是否预示其他药物的使用(多种药物使用)的证据有限。这项研究旨在确定大麻的使用是否预示着其他物质的共同使用。方法:我们分析了牙买加2013年全国中学调查的数据，使用推论统计来确定关联。结果:男性(X2 = 282.72, p = 0.000)和女性(X2 = 434.32, p = 0.000)终生大麻使用与终生香烟使用显著相关。同样，它与:(a)男性(X2 = 88.62, p = 0.000)和女性(X2 = 99.48, p = 0.000)终生饮酒显著相关;(b)男性(X2 = 13.28, p = 0.00)和女性(X2 = 49.56, p = 0.00)终生吸入剂使用情况;(c)男性(X2 = 9.78, p = 0.00)和女性(X2 = 64.54, p = 0.00)终生可卡因使用情况。过去一个月(最近)使用大麻与男性和女性过去一个月使用香烟和酒精(但不使用吸入剂)显著相关。Logistic回归结果显示，终生使用大麻是终生使用香烟的危险因素(调整优势比[AOR]: 11.38;95%可信区间[CI]: 9.02, 14.37)和酒精(AOR: 5.84;95%可信区间:4.11,8.30)，但对终生使用吸入剂和可卡因有很强的保护作用。过去一个月使用大麻是防止过去一个月使用香烟和酒精的有力保护因素。结论:终生使用大麻与多种物质使用显著相关，并被证明是终生使用香烟和酒精的一个危险因素。然而，报告最近(过去一个月)使用大麻的青少年报告最近使用酒精和香烟的可能性较小。这些发现表明，需要进一步研究大麻在多种药物使用中的作用，并为其作用提供更具体的解释。
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