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At least 19 recordsLinked to original sources
PubMed1978

Some non-infective diseases endemic in the West Indies.

The West Indies, and associated parts of the Caribbean area, are extremely diverse and afford interesting examples for the study of geographical medicine. Short accounts are given of some conditions whose aetiologies have been relatively recently clarified, including vomiting sickness of Jamaica, veno-occlusive disease of Jamaica, blackfat pulmonary fibrosis of Guyana, and epidemic acute glomerulonephritis of Trinidad. The aetiology of tropical sprue, which is common in Puerto Rico and absent from Jamaica remains to be explained although a hypothesis has been put forward. Further work is needed to establish the geographical distribution of idiopathic cardiomegaly and the spinal neuropathies and associated syndromes of retrobulbar neuritis and sensorineural deafness before their aetiologies can be understood.

Adult↗
PubMed1982

The use of corporal punishment in child rearing in the West Indies.

The West Indian child is usually loved by its parents or caretakers, but is frequently subjected to corporal punishment unsuitable to the age and stage of its development and excessive in relation to the alleged offence. The debate on whether the persistent use of what is considered excessive punishment as the means of instilling obedience in children, centres around the parents' African heritage or learned behaviour from the institution of slavery. Socially and economically disadvantaged parents under stress seem to displace their frustrations and anxieties on the children through corporal punishment which often assumes ritualised characteristics. The community in general and the parents in particular need help through appropriate education, to change their attitudes of accepting excessive corporal punishment as the means of imposing discipline upon children.

Child↗
PubMed1989

Population evolution of the free-living stage of goat gastrointestinal nematodes on herbage under tropical conditions in Guadeloupe (French West Indies).

In Guadeloupe (French West Indies), paddocks were contaminated with gastrointestinal helminth eggs by young goats during the rainy season and the dry season. The evolution of L3 population size on herbage was followed over a period of 56 days. The major genera were Haemonchus and Trichostrongylus. It was shown that the L3 appeared on herbage 7-14 days after the beginning of contamination (DAC), and the L3 population sizes were maximal between the 14th and the 21st DAC. The maximum duration of larval survival ranged between 49 and 56 days. There was a marked depressive effect by the dry season on eggs hatching and L3 development with some arrested egg hatching in Trichostrongylus. The climatic events and the amount of dry matter on pastures during the grazing period appeared as the main important factors which could interfere with the overall evolution of the L3 population size and there was no preferential direction of L3 migration from faeces to herbage.

Animals↗
PubMed1989

Effects of irrigation on appearance and survival of infective larvae of goat gastro-intestinal nematodes in Guadeloupe (French West Indies).

In Guadeloupe (French West Indies), faeces from naturally infected goats were deposited during the dry season on three plots, irrigated with long (plot A) or short herbage (B) and non-irrigated with long herbage (C). Microclimatic data and the evolution of L3 population size in faeces, on soil surface and on herbage were followed over a period of 26 days. The initial nematode egg population was comprised of 58% Haemonchus contortus (HC), 25% Trichostrongylus colubriformis (TC) and 17% Oesophagostomum columbianum (OC). Temperature and water content varied in time and space (soil, faeces, herbage) from homogeneous in A to very heterogeneous in C. In A and B, population dynamics were similar with higher values of maxima in A. Larval peaks occurred on day 9 after deposition in faeces in plot A: 23.1, 39.1 and 17.2 L3/100 eggs, respectively for HC, TC and OC; the same day in soil: 1.9, 0.6 and 3.1 L3/100 eggs. On day 26 it remained less than 1 L3/100 eggs in both soil and herbage for the three species. In C, only TC larvae were observed coming, after rain, from eggs in which hatching had been delayed. It was difficult to separate the respective effects of temperature and water content on the development of the eggs, but irrigation gave favourable conditions for all eggs to develop into larvae. Pasture rotation with 28-35 days of regrowth should minimize the increased risk of infection for the goats due to irrigation.

Animals↗
PubMed1991

Is MRCP (U.K.) a redundant qualification for graduates of D.M. (Internal Medicine), University of the West Indies?

M.R.C.P.(U.K.) and D.M. (Internal Medicine), University of the West Indies, are postgraduate qualifications that did, or now do, evaluate and set the quality of specialist Internal Physician training. Since the inception of the degree, graduates of D.M. (Internal Medicine), University of the West Indies, have developed sub-specialty interests and have been recognized as being of consultant status throughout the region and the world. D.M. is of a higher standard as it is an exit examination whereas the MRCP(U.K.) diploma is an entrance examination. Acquisition of the MRCP (U.K.) is expensive; travel to the U.K. is mandatory. Possession of MRCP (U.K.) is considered by most graduates of D.M. (Internal Medicine), University of the West Indies, to be unnecessary; it has not advanced their career in any discernible way. It should no longer be encouraged in any way at the University of the West Indies.

Education, Medical, Graduate↗
PubMed2001

An evaluation of medical school education in musculoskeletal medicine at the University of the West Indies, Barbados.

At the University of the West Indies, Cave Hill campus, the Freedman and Bernstein musculoskeletal competency examination was administered to 22 medical students during the last month of their final year. Eighty-two per cent (82%) of the students failed to score above the passing score of 73.1%. Nineteen of the twenty-two students had taken an orthopaedic elective or rotation during their final two years. The questions were also categorized as Anatomy, Trauma and General Orthopaedics. All students failed to score above the passing score in Anatomy. Sixty-four per cent (64%) failed in Trauma and 45% failed in General Orthopaedics. This study suggests that inadequacies in medical school preparation do exist at this campus of the University of the West Indies and the findings mirror those at medical schools in the United States of America.

Education, Medical↗
PubMed2001

Research, health policies and health care in the Caribbean. The role of the University of the West Indies.

The University of the West Indies has had a major impact on the provision of health care and the health of Caribbean nations over the last 50 years, through undergraduate, postgraduate and continuing medical education, research, outreach and public service. These roles are fully accepted, and the Faculties of Medical Sciences and School of Clinical Medicine and Research have provided most of the doctors now serving the English-speaking Caribbean, including academic leaders and chief medical officers. The design of a curriculum to produce doctors "designed" for the region has been a well-articulated goal, and the need to carry out relevant and essential national health research is now accepted. But the broader roles of ensuring translation of research into policy and practice, and developing effective ways of promoting on-going continuing training and behaviour change are far from understood or seriously attempted. Communication of research findings and evidence-based practice is crucial. The West Indian Medical Journal clearly has a valuable role to play here and this requires expansion and support. But a multi-faceted approach to communicating research findings and translating evidence into policy, planning and care is necessary. One possible approach would be a University Unit of Health Policy Research and Development.

Delivery of Health Care↗
PubMed2001

Fifty years of clinical examinations at the University of the West Indies.

The University of the West Indies was founded at Mona, Jamaica, in 1948. After fifty-two years, the format of the final Bachelor of Medicine clinical examination in Medicine and Therapeutics has been radically revised. The change from the traditional to an evidence-based, objective structured clinical examination (OSCE) was undertaken in November/December 2000. Assessment drives learning and both the methods chosen for assessment and the manner in which they are applied determine how students learn. The philosophical underpinnings of the change in format are discussed in this paper.

Clinical Competence↗
PubMed1987

Multiple sclerosis among the United Kingdom-born children of immigrants from the West Indies.

Multiple sclerosis has been reported to be very uncommon in the West Indies. In previous studies immigrants from the West Indies resident in Greater London had only one-eighth the likelihood of being diagnosed in hospital as having multiple sclerosis compared with those born in the United Kingdom. No studies of the incidence and prevalence of multiple sclerosis were available for London or South East England but there is evidence that it is much the same as occurs in Ireland. In the age groups studied the United Kingdom-born children of West Indian immigrants had an incidence and prevalence of probable multiple sclerosis of the same order as has been reported in Northern Ireland and in the Irish Republic. Although there is evidence that genetic factors play a part, our findings are strong evidence that the cause of the disease is mainly environmental and is therefore potentially preventable.

Adolescent↗
PubMed1994

[Ultrasonographic fetal growth curves in the West Indies. Apropos of 2930 measures of 889 fetuses].

OBJECTIVE: To establish the echographic foetal growth curves between 20 and 40 weeks amenorrhoea in the specific population of the West Indies. SITE. Gynecology-Obstetrics Unit, Redoute Hospital, Fort-de-France. POPULATION: All echographies performed between the 20th and 40th week of amenorrhoea in single foetus pregnancies in women of local origin who had undergone an echography before 15 weeks of amenorrhoea were included. Major malformations and chromosomic abnormalities were excluded. METHODS: A total of 2,930 measurements of the biparietal, transverse abdominal diameters and length of femur were recorded in 889 foetuses. The curves for the 10th, 50th and 90th percentiles were constructed by smoothing with a second end linear curve for each of the echographic parameters. For each parameter, the growth curves were compared with the curves established by Leroy and Bessis for the French population. The difference in the growth curves between the two populations were correlated to gestational age in order to establish whether there is a difference between the West Indies population and the metropolitan French population. RESULTS: Comparison with the Leroy and Bessis curves revealed that the rate of growth in the transverse abdominal diameter and the length of femur was significantly different between the West Indies population and the French population (p < 0.01). Inversely, the rate of growth of the biparietal diameter was comparable for the two populations. CONCLUSION: These growth curves provide echographists and obstetricians who examine patients of West Indies origin to adapt their obstetrical management. An ethnic factor cannot be excluded in explaining the difference between the two populations. This study confirms the requirement to establish foetal growth curves of each separate region.

Abdomen↗
PubMed1979

Studies of the relationship between Schistosoma and their intermediate hosts. III. The genus Biomphalaria and Schistosoma mansoni from Egypt, Kenya, Sudan, Uganda, West Indies (St. Lucia) and Zaire (two different strains: Katanga and Kinshasa).

The compatibility between strains of Schistosoma mansoni from Egypt, Kenya, Sudan, Uganda, the West Indies, and Zaire (two strains which came from Katanga and from Kinshasa), and various species and strains of Biomphalaria, i.e. Biomphalaria pfeifferi, B. alexandrina, B. glabrata and B. camerunensis was investigated. Data as mortality, rate of infection of the surviving snails, duration of infection, cercarial production per day per positive snail, etc., were observed. The main emphasis was placed on determining the total cercarial production per 100 exposed snails for each snail population. It was possible to infect all the tested populations of B pfeifferi with the various strains of S. mansoni, but the observation as e.g. TCP/100 exposed snails varied greatly according to the population of snail and the strain of S. mansoni. The results for the remaining species of Biomphalaria varied greatly, depending on the combination, e.g. B. alexandrina was only susceptible to the local S. mansoni from Egypt. The highest TCP/100 exposed snails was more than 1 million for the strains of S. mansoni from Egypt, Kenya and the West Indies in B. alexandrina, B. pfeifferi and B. glabrata, respectively. The next group, with a TCP/100 exposed snails on 7--800 000 consists of S. mansoni from Sudan, Uganda and Zaire (Katanga) all in B. pfeifferi. The last tested strain of S. mansoni, Zaire (Kinshasa) yielded a cercarial production on 500 000 per 100 exposed snails in B. pfeifferi and B. camerunensis. The shortest prepatent period, 19 days, was observed for S. mansoni from Kinshasa, Zaire, in B. camerunensis, and the longest prepatent period, 25 days, was found for strains from Egypt and from the West Indies in B. alexandrina and B. glabrata, respectively. In general, a very long duration of infection, lasting up to 200 days, was observed.

Animals↗
PubMed2002

Problem-based compared with traditional methods at the Faculty of Medical Sciences, University of the West Indies: a model study.

The University of the West Indies (UWI) comprises three campuses located on three different islands. Two of the Campuses, Mona in Jamaica and St Augustine in Trinidad & Tobago offer full medical programmes, i.e. both basic sciences and clinical training. At Cave Hill, where basic sciences courses are not offered, students are drawn from the traditional school at Mona or the Problem Based Learning (PBL) school at St Augustine to follow a common clinical programme. After 24 months of clinical training consisting of a minimum of 12 clerkships these students take identical examinations in Medicine & Therapeutics, Surgery and Obstetrics & Gynaecology. In this paper the results of the final clinical examinations at Cave Hill for the five-year period 1995-99 have been analysed, comparing the performances of students drawn from Mona with those from St Augustine. We found that, except for a few isolated cases, there were no significant differences in the performance of the two groups of students. These results suggest that the delivery of a significant component of a basic sciences programme by a well-planned PBL system is unlikely to produce substandard students at the end of their clinical training.

Clinical Clerkship↗
PubMed1982

Adult T-cell lymphoma-leukaemia in Blacks from the West Indies.

Six Black patients (five born in the West Indies and one in Guyana), aged 21-55 years, had adult T-cell lymphoma-leukaemia diagnosed in the U.K. This disorder is rare in Europe and the U.S.A., but is more common in Japan. Five patients had severe hypercalcaemia which correlated with disease activity, although osteolytic lesions were found in only one. Other clinical features were lymphadenopathy and a high white blood-cell count (range 27-67 X 10(9)/l) with a predominance of pleomorphic lymphoid cells with pronounced nuclear irregularities prominent at ultrastructural level. The cells in all cases formed rosettes with sheep red blood-cells and lacked terminal transferase. Analysis with OKT monoclonal antibodies in four cases confirmed a mature T-cell phenotype defined as helper/inducer (T4+, T6-, T8-) in three. Combination chemotherapy resulted in short-lived remissions; four patients died and two have survived 3-6 months. The disease in these patients is indistinguishable on clinical and pathological grounds from adult T-cell leukaemia/lymphoma in Japan. Geographical clustering among certain racial groups suggests common aetiological factors in the pathogenesis of this disease. The finding of high titre antibody against the structural core protein (p24) of a new human C-type leukaemia virus (human T-cell leukaemia/lymphoma virus) in all tested cases from this series and data from all but one case from Japan suggest that one such factor may be viral.

Adult↗
PubMed1993

Ethics and law in the medical curriculum--a university of the West Indies perspective.

The Faculty of Medical Sciences (FMS), University of the West Indies, recognizes that ethics and law are not currently given adequate importance in the training of health professionals. FMS also recognizes the rapid advancement of technology, such as transplants, artificial organs, in vitro fertilization, life-sustaining equipment and euthanasia, as well as the ever-increasing prevalence of malpractice. Thus, two conferences were held to consider the implementation of ethics and law in the medical curriculum. The conferences recommended an increased input into the curriculum of ethics and law, and that this programme be taught and examined in all the medical years. The article discusses implementation strategies.

Bioethical Issues↗
PubMed1998

Helminths of six species of Anolis lizards (Polychrotidae) from Hispaniola, West Indies.

From Hispaniola, an island in the West Indies, 6 species of anoles, Anolis cristatellus, Anolis etheridgei, Anolis eugenegrahami, Anolis hendersoni, Anolis monticola, and Anolis olssoni were examined for helminths. Helminths representing 2 species of trematodes, Mesocoelium monas and Urotrema scabridum; 1 species of cestode, Oochoristica maccoyi; 11 species of nematodes, Atractis scelopori, Oswaldocruzia lenteixeirai, Parapharyngodon cubensis, Skrjabinoptera leiocephalorum, Trichospirura teixeirai, Ascarops sp., Physocephalus sp., Porrocaecum sp., Rhabdias sp., Acuariidae gen. sp. and Cosmocercidae gen. sp.; and 1 species of acanthocephalan, Centrorhynchus sp., were found. Skrjabinoptera leiocephalorum, Ascarops sp., and Physocephalus sp. from A. cristatellus and all helminths recovered from the other 5 anole species represent new host records.

Acanthocephala↗
PubMed2001

Kenneth Harrison Uttley (1901-1972). Historian to the diseases of Antigua, British West Indies.

Dr Kenneth Harrison Uttley (1901-1972) served as the Chief Medical Officer in Antigua, British West Indies, from 1955 until 1966. During this time, Dr. Uttley personally reviewed and tabulated an island-wide governmental demographic database of all births, deaths and causes of death during the preceding 100 years. This database was the result of a Compulsory Birth and Death Registration Ordinance enacted as one of several Colonial Poor Laws in 1856. His efforts resulted in the publication of a total of 30 papers in American and British medical journals. Many of these papers reviewed historical demographic trends in births, fertility rates, neonatal deaths, infant mortality and early childhood mortality rates. Others focussed on the historical epidemiology of specific diseases such as neonatal tetanus, leprosy, tuberculosis and malaria. This is the first complete bibliographical account of Uttley's contributions to the history of diseases in the West Indies in general and Antigua in particular. Dr Uttley also served as an ordained priest in the Anglican Church and, upon retirement from the Colonial Medical Services, returned to England to serve as the Vicar of Purton, Oxfordshire.

Antigua and Barbuda↗