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Background. Family-based strategies to reduce the risk of overweight in childhood are needed in the Caribbean. Aim. To investigate the associations between parental characteristics and risk of overweight and explore possible mechanisms. Methods. Data from a parenting intervention were analysed. Parental characteristics were obtained by questionnaire at enrolment. At 18 months, 501 infants (82.9% of cohort) had weight and length measured using standardized methods. The association of parents' characteristics with risk of infant overweight was assessed using random-effects logistic regression. Four focus groups among mothers in Jamaica were conducted to explore mechanisms. Results. Overall, 20.6% of infants were 'at risk of overweight'. Fathers were present in 52% of households. Fathers' presence [OR (95% CI) 0.60 (0.37-0.96)] was associated with reduced risk of overweight independent of socioeconomic status. Mothers reported that fathers encouraged healthier practices. Conclusion. Fathers may be important agents of change in intervention strategies to prevent childhood overweight. [ABSTRACT FROM AUTHOR]

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Aim: This study sought to identify adolescents' health information sources and determine the gap between what adolescents want to hear and what they actually hear from their healthcare providers (HCPs), a proxy for unmet health needs., Methods: A cross-sectional study was conducted in four high schools conveniently selected in Jamaica to ensure adequate representation in rural and urban locales. Adolescents 11-19 years old with relevant assent/consent completed a paper-based self-administered questionnaire. Questions were adapted from the Young Adult Health Care Survey to determine proportion of adolescents receiving confidential care, the level of counselling offered and difference between location and unmet needs., Results: Adolescents acknowledged multiple sources of information, with urban adolescents reporting television, radio and parents as sources more frequently than in rural setting (p < 0.05). They most commonly wanted to discuss weight management (n = 308, 64.2%), nutrition (n = 418, 87.1%), exercise (n = 361, 75.2%); and emotions they are experiencing (n = 246, 51.3%). Unmet needs differed by location; more rural than urban adolescents found that their desire to discuss school performance (p < 0.05) and sexual orientation (p < 0.05) was unmet, while more urban youth felt their need for discussions about STIs was unmet (p < 0.05), when compared to their rural counterparts., Conclusion: This study highlights that while there is some access to health information in Jamaica, especially via television, radio and internet, the needs of the adolescent population remain unmet. HCPs need to employ a patient-centred approach where confidentiality is established and screening is done for unmet needs in an effort to optimize health outcomes., (© The Author(s) [2023]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Transforming the urban infrastructure to become safe, inclusive and sustainable remains a challenge in most developing settings. The Caribbean has high burdens of physical inactivity and non-communicable diseases. Therefore, understanding the role of the built environment (BE) in modifying individual activity is important for informing the design of community interventions to improve levels of physical activity (PA). Anecdotally, there is limited evidence on the BE in the Caribbean, however evidence from other Small Island Developing States (SIDS) and from Latin America (LA) may offer useful information given their similar urbanization profiles and shared geo-collaborative histories., Objective: Our review identifies and characterizes individual features of the BE and examines their relationships with PA outcomes., Methods: We systematically searched a range of multi-discipline research databases, including studies from SIDS and LA that objectively measured BE features as an exposure and PA as an outcome between 2010 and 2021. Grey literature was not considered for this review. We characterized BE measures into 9 neighbourhood design domains using the Walkability for Health framework, and mapped gaps in the published evidence. We performed a narrative summary of BE-PA relationships, focusing on association strength and direction of effect., Results: Fifty-one studies from published scientific literature in Brazil, Colombia, Mexico, Chile, and Singapore were included that described 306 BE-PA relationships. The BE was mostly characterized by number of and proximity to spaces for social interaction, green spaces, increasing housing density or street connectivity, and mixed residential and commercial land use. BE-PA relationships, although inconsistent, largely promoted PA., Conclusion: Although the review is suggestive of the benefits of the benefits of BE interventions for promoting active commuting and leisurely PA, translational research is needed to understand whether results can be successfully adapted for SIDS, which often have an urban structure defined by a single urban centre with connections to outlying communities., Competing Interests: The authors declare that they have no conflict of interests., (© 2022 The Authors. Published by Elsevier Inc.)

Objective: To describe features of nutritional interventions implemented in Small Island Developing States (SIDS) in the past 20 years., Methods: A rapid scoping review was conducted by searching PubMed and Web of Science databases for interventions conducted in SIDS that sought to improve the nutrition of their populations between 2000 and 2019 inclusive. The Noncommunicable diseases progress monitor 2020 was also examined to assess nutritional policies in SIDS., Results: A total of 174 interventions were implemented in 49 of the 58 SIDS. The greatest proportion were conducted in the Caribbean (75 interventions; 43%), with the Pacific region, and the Atlantic, Indian Ocean, Mediterranean and South China Sea region each implementing about 30% of interventions. Using the NOURISHING framework, most interventions (67%) were implemented at the community and national or policy level, using multiple components of the framework. The greatest proportion of interventions (35%) were educational and awareness raising. Restrictions on physical availability of and increased taxation on alcohol were the most commonly reported policies that were partially or fully achieved; restrictions on fats were the least commonly reported. These findings were generally consistent across the SIDS regions., Conclusions: There is a paucity of nutritional policies in SIDS; the reasons may be linked to their social, economic, and environmental vulnerabilities. Interventions should be expanded beyond education to encompass multiple components of the NOURISHING framework, with multisectoral inclusion to ensure stronger stakeholder collaboration and buy-in. A systematic review is warranted using a fuller range of sources to assess the effectiveness of interventions.

The prevalence of depression remains particularly high among university students. Factors known to be associated with this high burden range from social to poor academic performance. Thus, this study sought to determine the prevalence and predictors of depression and perceived stress among university students attending a Caribbean university. This was a cross-sectional study involving 800 students. Depression was assessed using the 21-item Beck Depression Inventory (BDI) and perceived stress was assessed using the Cohen Perceived Stress Scale. Logistic regression models were used to examine the relationship between predictors on depression and perceived stress. The BDI score was 11.97 ± 8.77 with a prevalence of depression at 25.88% and perceived stress of 57.50%. Living or associating with family and friends, were significant predictors of depression while school, money and associating with family/friends were significant for perceived stress. Talking with someone and exercise were associated with a lower likelihood of depression, while eating, drinking alcohol and shopping were associated with reduced levels of perceived stress. The level of depression and perceived high stress in this populations was moderate compared to similar international populations. These findings can be used to inform and design future interventions to improve the mental health of university students.

Ultrasound (US) shear wave technology providers have either point shear wave elastography (SWE) or 2-dimensional SWE available on their US systems. With 2-dimensional SWE, larger regions of interest can be interrogated, with both the main acoustic radiation pulses and the resultant shear waves potentially being affected by US artifacts. Some providers assist the operator with elastographic maps indicating the reliability or precision of the shear wave propagation. This Technical Innovation explores the importance of the consideration of the precision maps and standard deviation output available on some devices and the implications for conversion of shear wave speed to pressure., (© 2019 by the American Institute of Ultrasound in Medicine.)

Objective: This study developed and explored the validity of the Children's Kitchen Task Assessment (CKTA), a performance assessment of executive function., Method: The development of the CKTA is described. Children were given the CKTA and neuropsychological assessments of executive functioning. Parents completed the Parent Behavior Rating Inventory of Executive Function (Parent BRIEF)., Results: Forty-nine typically developing children ages 8 to 12 years participated in this study. Interrater reliability and internal consistency were established. Preliminary evidence of discriminant validity was reflected in significant differences on neuropsychological tests and the Parent BRIEF between high- and low-scoring CKTA groups. Age-related differences in CKTA performance further supported discriminant validity. Support for concurrent validity was observed in moderate correlations with established neuropsychological tests., Conclusion: Preliminary results suggest the CKTA is a valid performance assessment that evaluates the level of cognitive assistance children require to complete a challenging functional activity.

Setting: Underdiagnosis of chronic obstructive pulmonary disease (COPD) in asthmatics attending specialty care in Trinidad, West Indies., Objective: To determine the prevalence of COPD in diagnosed asthmatics receiving specialty respiratory care., Design: In a cross-sectional study, 258 asthmatics were screened for lung function measures to examine forced expiratory volume after 1 second (FEV1), forced vital capacity (FVC) and post-bronchodilator FEV1/FVC (COPD was defined as FEV1/FVC < 70%)., Results: Of 165 patients evaluated (response rate 64.0%), 53 (32.1%, 95%CI 25.0-39.2) had a study diagnosis of COPD and a mean FEV1/FVC of 60.12 +/- 1.2. Proportionally, more males had COPD (50.9%) than asthma (24.1%, P < 0.001). Patients with COPD were 10 years older than asthmatics (P < 0.001). Persons with asthma who smoked were more likely to have COPD (56.0%) (OR 3.26, 95%CI 1.36-7.80, P = 0.006). In both sexes, FEV1/FVC was lower among older people (P < 0.001), with a greater effect (OR 2.75, 95%CI 1.00-7.56, P < 0.01) seen among men in this cross-sectional study., Conclusions: One third of diagnosed asthmatics in specialty care also have COPD. Lung function was lower among older persons. Early spirometric evaluation of elderly asthmatics who smoke can determine the presence of COPD and facilitate appropriate management.