Search

We identified 3 clades of dengue virus serotype 3 belonging to genotype III isolated during 2019–2020 in Jamaica by using whole-genome sequencing and phylogenomic and phylogeographic analyses. The viruses likely originated from Asia in 2014. Newly expanded molecular surveillance efforts in Jamaica will guide appropriate public health responses. [ABSTRACT FROM AUTHOR]

Positive Plus One is a mixed-methods study of long-term mixed HIV-serostatus relationships in Canada (2016–19). Qualitative interviews with 51 participants (10 women, 41 men, including 27 HIV-positive and 24 HIV-negative partners) were analyzed using inductive thematic analysis to examine notions of relationship resilience in the context of emerging HIV social campaigns. Relationship resilience meant finding ways to build and enact life as a normal couple, that is, a couple not noticeably affected by HIV, linked to the partner with HIV maintaining viral suppression and achieving "undetectable = untransmittable" (U = U). Regardless of serostatus, participants with material resources, social networks, and specialized care were better able to construct resilience for HIV-related challenges within their relationships. Compared to heterosexual couples and those facing socioeconomic adversity, gay and bisexual couples were easier able to disclose, and access capital, networks and resources supporting resilience. We conclude that important pathways of constructing, shaping, and maintaining resilience were influenced by the timing of HIV diagnosis in the relationship, access to HIV-related information and services, disclosure, stigma and social acceptance. [ABSTRACT FROM AUTHOR]

Introduction: Substance-related acute toxicity deaths continue to be a serious public health concern in Canada. This study explored coroner and medical examiner (C/ME) perspectives of contextual risk factors and characteristics associated with deaths from acute toxic effects of opioids and other illegal substances in Canada. Methods: In-depth interviews were conducted with 36 C/MEs in eight provinces and territories between December 2017 and February 2018. Interview audio recordings were transcribed and coded for key themes using thematic analysis. Results: Four themes described the perspectives of C/MEs: (1) Who is experiencing a substance-related acute toxicity death?; (2) Who is present at the time of death?; (3) Why are people experiencing an acute toxicity death?; (4) What are the social contextual factors contributing to deaths? Deaths crossed demographic and socioeconomic groups and included people who used substances on occasion, chronically, or for the first time. Using alone presents risk, while using in the presence of others can also contribute to risk if others are unable or unprepared to respond. People who died from a substance-related acute toxicity often had one or more contextual risk factors: contaminated substances, history of substance use, history of chronic pain and decreased tolerance. Social contextual factors contributing to deaths included diagnosed or undiagnosed mental illness, stigma, lack of support and lack of follow-up from health care. Conclusion: Findings revealed contextual factors and characteristics associated with substance-related acute toxicity deaths that contribute to a better understanding of the circumstances surrounding these deaths across Canada and that can inform targeted prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Introduction: Substance-related acute toxicity deaths continue to be a serious public health concern in Canada. This study explored coroner and medical examiner (C/ME) perspectives of contextual risk factors and characteristics associated with deaths from acute toxic effects of opioids and other illegal substances in Canada. Methods: In-depth interviews were conducted with 36 C/MEs in eight provinces and territories between December 2017 and February 2018. Interview audio recordings were transcribed and coded for key themes using thematic analysis. Results: Four themes described the perspectives of C/MEs: (1) Who is experiencing a substance-related acute toxicity death?; (2) Who is present at the time of death?; (3) Why are people experiencing an acute toxicity death?; (4) What are the social contextual factors contributing to deaths? Deaths crossed demographic and socioeconomic groups and included people who used substances on occasion, chronically, or for the first time. Using alone presents risk, while using in the presence of others can also contribute to risk if others are unable or unprepared to respond. People who died from a substance-related acute toxicity often had one or more contextual risk factors: contaminated substances, history of substance use, history of chronic pain and decreased tolerance. Social contextual factors contributing to deaths included diagnosed or undiagnosed mental illness, stigma, lack of support and lack of follow-up from health care. Conclusion: Findings revealed contextual factors and characteristics associated with substance-related acute toxicity deaths that contribute to a better understanding of the circumstances surrounding these deaths across Canada and that can inform targeted prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Background: Most universities around the world use the multiple-choice question (MCQ) examination format to evaluate medical education. However, the suitability and advantages of traditional MCQs and extended matching questions (EMQs) continue to be debated. Objectives: This study mainly aimed to perform a comprehensive comparative analysis of the performance of the EMQ and traditional MCQ formats in the final MBBS exit examination. Methods: We conducted an item analysis of 80 EMQs, and 200 MCQs administered to 532 examinees across the four campuses of the University of the West Indies during the final MBBS medicine and therapeutics examination of 2019. Exam performance measures included central tendency, item discrimination, reliability, item difficulty, and distractor efficacy. Results: For the 532 students who sat the exam, the highest, lowest, and mean (± SD) scores for the EMQs were 93, 41, and 69.0 (± 9.8), respectively; for the MCQs, the respective values were 82, 41, and 62.7 (± 7.4). The predictive value of the EMQ and MCQ grades individually in the overall failure was 0.67 (95% CI = 0.39, 0.87) and 0.89 (95% CI = 0.65, 0.98), respectively. KR-20 coefficients for the EMQs and MCQs ranged from 0.52 to 0.70 and 0.71 to 0.79, respectively. The proportion of questions with two or more functional distractors was consistently higher for the MCQs than for the EMQs in all four cohorts of students. Conclusions: The MCQs were more predictive of the overall failure and had higher inter-item reliability, making the MCQ format more suitable for high-stakes examinations. [ABSTRACT FROM AUTHOR]

Background: With the recent shift in focus to addressing HIV risk within relationships and couple-based interventions to prevent HIV transmission, successful recruitment of individuals involved in HIV-serodiscordant relationships is crucial. This paper evaluates methods used by the Positive Plus One (PP1) study to recruit and collect data on a diverse national sample of dyads and individuals involved in current or past HIV-serodiscordant relationships, discusses the strengths and limitations of the recruitment approach, and makes recommendations to inform the interpretation of study results and the design of future studies.Methods: PP1 used a multi-pronged approach to recruit adults involved in a current or past HIV-serodiscordant relationship in Canada from 2016 to 2018 to complete a survey and an interview. Upon survey completion, index (first recruited) partners were invited to recruit their primary current HIV-serodiscordant partner. We investigated participant enrollment by recruitment source, participant-, relationship-, and dyad-level sociodemographic characteristics, missing data, and correlates of participation for individuals recruited by their partners.Results: We recruited 613 participants (355 HIV-positive; 258 HIV-negative) across 10 Canadian provinces, including 153 complete dyads and 307 individuals who participated alone, and representing 460 HIV-serodiscordant relationships. Among those in current relationships, HIV-positive participants were more likely than HIV-negative participants to learn of the study through an ASO staff member (36% v. 20%, p < 0.001), ASO listserv/newsletter (12% v. 5%, p = 0.007), or physician/staff at a clinic (20% v. 11%, p = 0.006). HIV-negative participants involved in current relationships were more likely than HIV-positive participants to learn of the study through their partner (46% v. 8%, p < 0.001). Seventy-eight percent of index participants invited their primary HIV-serodiscordant partner to participate, and 40% were successful. Successful recruitment of primary partners was associated with longer relationship duration, higher relationship satisfaction, and a virally suppressed HIV-positive partner.Conclusions: Our findings provide important new information on and support the use of a multi-pronged approach to recruit HIV-positive and HIV-negative individuals involved in HIV-serodiscordant relationships in Canada. More creative strategies are needed to help index partners recruit their partner in relationships with lower satisfaction and shorter duration and further minimize the risk of "happy couple" bias. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance (ABR) is a serious threat that requires coordinated global intervention to prevent its spread. There is limited data from the English-speaking Caribbean. Methods: As part of a national programme to address antibiotic resistance in Jamaica, a survey of the knowledge, attitudes and antibiotic prescribing practices of Jamaican physicians was conducted using a 32-item self-administered questionnaire. Results: Of the eight hundred physicians targeted, 87% responded. The majority thought the problem of resistance very important globally (82%), less nationally (73%) and even less (53%) in personal practices. Hospital physicians were more likely to consider antibiotic resistance important in their practice compared to those in outpatient practice or both (p < 0.001). Composite knowledge scores were generated and considered good if scored > 80%, average if 60-79% and poor if < 60%. Most had good knowledge of factors preventing resistance (83%) and resistance inducing potential of specific antibiotics (59%), but only average knowledge of factors contributing to resistance (57%). Knowledge of preventative factors was highest in females (p = 0.004), those with postgraduate training (p = 0.001) and those > four years post graduation (p = 0.03). Empiric therapy was often directed by international guidelines and cultures were not routinely done. Limited laboratory and human resources were identified as challenges. Conclusion: Physicians in this study were aware of the problem of ABR, but downplayed its significance nationally and personally. These results will guide a national antibiotic stewardship programme. [ABSTRACT FROM AUTHOR]

As traditional education transitioned from face-to-face interactions to virtual learning during the COVID-19 pandemic, faculty and staff in dental hygiene, nursing, and exercise science programs placed students at the center of every educational decision and promoted stability in learning with their commitments to excellence in teaching and the delivery of content using educational and communication technology. This experiential narrative review explains how faculty members and administrators addressed online education with technology specific to health professions and how universities managed to assist students with innovative services for mental health. It also provides an insight into how degree-specific academic personnel embraced technology-based hands-on activities in community health clinics and clinical laboratories, with sustainable and impactful lessons in equity, affordability, and transformative education. Finally, health administrators gather their top-10 leadership recommendations to continue moving forward during the pandemic and present a unique self-reflection on the process of caring considerations required for a successful experience for faculty members, staff, and students. [ABSTRACT FROM AUTHOR]

Background The gastrointestinal tract is a common site of involvement in HIV-infected patients. Gastrointestinal symptoms are common in the general population and are associated with decreased quality of life. Methods Ambulatory consecutive HIV-infected patients and consecutive healthy blood donors seen in Jamaica were studied. A 19-item questionnaire of GI symptoms was administered. Results There were 196 respondents. Among 99 HIV patients, the mean number of symptoms was 2.9 and in 97 controls 3.3 (p=0.091). Dysphagia and odynophagia were present in 8.1% of HIV patients and 3.1% of the controls (p=0.129). Belching was present in 59.6% of HIV patients and in 96.8% of controls (p≤0.001). In the control group, 44.3% had heartburn compared to 29.3% of HIV patients. Within the preceding year, 26.3% of HIV participants and 12.4% of controls sought medical attention for their GI symptoms (p=0.001). GI symptomatology was directly related to immune status in the HIV group as patients with a CD4 count of less than 200 cells/µL reported up to 6 GI symptoms, those with CD4 of 201-350 cells/µL had 3 symptoms, and patients with CD4 greater than 351 cells/µL had 1 symptom. Pain on swallowing, and vomiting were significantly more common in patients with CD4 <350 cells/µL than in controls. Conclusions GI symptoms were common in HIV patients and controls. In HIV patients symptoms were directly related to CD4 count. Pain on swallowing and vomiting were significantly more common in patients with CD4 <350 cells/µL than in controls. [ABSTRACT FROM AUTHOR]

Professional guidelines recommend that the psycho-social implications of living with a stutter should be assessed, and that therapy should target the emotional and cognitive aspects of living with a stutter (Taylor-Goh, 2005). Very little evidence exists about how speech and language therapists (SLTs) evaluate success of therapy or determine discharge criteria. The aim of the research reported here, which was part of a larger study of current SLT practice among clinicians working with adults who stutter, was to discover how SLTs (1) evaluate success in therapy and (2) determine whether to discharge a client who stutters. A postal self-administered questionnaire was distributed to SLTs (n = 342) who work in Britain with adults who stutter. A response rate of 77.5% was achieved. Content analysis was used to analyse open ended questions about evaluation and discharge criteria. Many therapists adopt practice in line with recommendations from the literature, but some SLTs do not report that they use outcome measures to evaluate their practice, or suggest that they sometimes adopt inappropriate discharge criteria. Other SLTs use novel methods to assist with evaluation. [ABSTRACT FROM AUTHOR]

Aim: Human papillomavirus (HPV) has been reported to be associated with oral and oropharyngeal cancer. However, little information is available about the epidemiology of oral HPV infection in Jamaica. The purpose of the present study was to assess the prevalence of oral HPV strains using the oral rinse method in HIV and non‐HIV Jamaican patients, as well as to determine the association of HPV with sexual practices, smoking, and alcohol use. Methods: A cross‐sectional study was conducted on patients attending The University of the West Indies Mona Dental Polyclinic and the Centre for HIV/AIDS Research and Education Services. Salivary samples were tested through molecular analysis for 37 HPV genotypes using the linear array HPV genotyping test. A survey questionnaire was used to obtain demographic details, smoking history, alcohol practice, sexual practice, and history of HPV testing. Results: The HPV prevalence was 8.65% in 18‐64 y olds (N = 104), with a slight female predilection (55%). No high‐risk HPV types were found. HPV‐84 was the most common type in both HIV and non‐HIV patients; 66.7% of HPV‐positive participants reported that they had six or more lifetime sexual partners. Conclusion: The prevalence of oral HPV was similar to that in other countries. No statistically‐significant relationship was observed between the prevalence of HPV and either the number of sexual partners, smoking, or alcohol history. A nationwide study on oral HPV detection might be helpful in developing a HPV vaccination policy in Jamaica. [ABSTRACT FROM AUTHOR]

The original article [1] contains a major error whereby the present title does not display the correct wording as intended by the authors. [ABSTRACT FROM AUTHOR]