The societal economic impact of vision impairment in adults 40 years and above: findings from the National Eye Survey of Trinidad and Tobago.

BACKGROUND: Understanding and mitigating the societal economic impact of vision impairment (VI) is important for achieving the Sustainable Development Goals. AIM: To estimate the prevalent societal economic impact of presenting VI in Trinidad and Tobago using bottom-up cost and utilisation data from the 2014 National Eye Survey of Trinidad and Tobago. METHODS: We took a societal perspective to combine comprehensive, individual-level cost and utilisation data, with population-based prevalence estimates for VI, and additional data from a contemporaneous national eyecare system survey. We included direct (medical and non-medical) and indirect (productivity loss) costs, and intangible losses in total cost estimates, presented in 2014 Trinidad & Tobago (TT) dollars and UK sterling equivalent. We considered but excluded transfer payments and dead weight losses. Sensitivity analyses explored impact on total cost of parameter uncertainty and assumptions. RESULTS: Individual utilisation and cost data were available for 65.5% (n = 2792/4263) and 59.0% (n = 2516/4263) eligible participants aged ≥40 years, respectively. Participant mean age was 58.4(SD 11.8, range 40-103) years, 56.3% were female. We estimated total societal cost of VI in 2014 at UK£365,650,241 (TT$3,842,324,655), equivalent to £675 per capita (population ≥40 years). Loss of wellbeing accounted for 73.3%. Excluding this, the economic cost was UK£97,547,222 (TT$1,025,045,399), of which indirect costs accounted for 70.5%, followed by direct medical costs (17.9%), and direct non-medical costs (11.6%). CONCLUSION: This study provides a comprehensive estimate of the economic impact of vision loss in a Caribbean country, and highlights the extent to which affected individuals and their families bear the societal economic cost of vision impairment.

Falls in older people: comparing older and younger fallers in a developing country.

PURPOSE: While falls are common in older people, causing significant mortality and morbidity, this phenomenon has not been extensively studied in the Caribbean. This study aimed to compare falls in older and younger people in this setting. METHODS: We conducted a prospective observational study of older trauma patients in Trinidad, comparing older and younger patients sustaining falls. RESULTS: 1432 adult trauma patients were included (1141 aged 18-64 years and 291 aged 65 years and older). Older fallers were more likely to be female (66.7 vs 47.2%; p < 0.001), suffer from multiple pre-existing diseases (24.7 vs 2.4%; p < 0.001) and take multiple medications (16.1 vs 0.8%; p < 0.001). They also sustained more severe injuries and presented with higher acuity than younger fallers. Admission rates were higher among older fallers (29.9 vs 13.1%; p < 0.001). CONCLUSIONS: In our study, older patients who fell were a distinct group from younger falls victims, with unique demographic, clinical and injury related characteristics. Their increased risk of injury within the home, coupled with their propensity for more severe injuries made them a high risk patient group. More research is needed to better understand this patient group and plan specific preventive interventions.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad.

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7%) females and 502 (48.3%) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2%), while 249 (23.6%) of the total sample thought asthma was treated with AS. Most (872 or 82.1%) felt that their knowledge about AS was inadequate and 700 (66.0%) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0%) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9%, 95% CI 2.0-4.1). The prevalence of AS use was higher among males than females (p < 0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7 percent) females and 502 (48.3 percent) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2 percent), while 249 (23.6 percent) of the total sample thought asthma was treated with AS. Most (872 or 82.1 percent) felt that their knowledge about AS was inadequate and 700 (66.0 percent) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0 percent) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9 percent CI 2.0-4.1). The prevalence of AS use was higher among males than females (p<0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well-known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.(Au)

Knowledge, attitudes and practices of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym-users in 14 gyms in Trinidad from February 1997 to July 1997 to determine the knowledge, attitudes and practices regarding anabolic steroids (AS). Five hundred and sixty (52.7 percent) females and 502 (48.3 percent) males completed the questionnaire. Half of the total sample were individuals in the 20 to 29 year age group. From the 17 questions that tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79.2 percent), while 249 (23.6 percent) of the total sample thought asthma was treated with AS. Most (872 or 82.1 percent) felt that their knowledge about AS was inadequate and 700 (66.0 percent) were of the opinion that AS should be banned from use in competitive sports. Similarly, 733 (70.0 percent) of the gym-users thought AS should only be available by prescription. Thirty respondents reported having used AS (2.9 percent CI 2.0-4.1). The prevalence of AS use was higher among males than females (p<0.001). Improvement of physical appearance and not competitive advantage in sport was the main reason cited for AS use. Anabolic steroid users knew more about the adverse effects of AS than non-AS users but the therapeutic uses of AS were comparatively less well-known. This study demonstrated a general lack of knowledge concerning AS use and that a small but significant proportion of persons using gyms admitted to abusing AS.

Knowledge, attitude and practice of anabolic steroid usage among gym users in Trinidad

Self-administered questionnaires were completed by 1062 gym users in 14 gyms in Trinidad from February to July. 1997 tp determine , attitude and practices regarding anabolic steroids (AS). Five hundred and sixty (53 percent) females and 502 (48 percent) males participated with half of the total sample in the 20 to 29 year age group. From the 17 questions which tested knowledge about AS, the median number of correct responses was 7 with a mode of 8. Increased muscle mass was correctly identified as one of the effects of AS by 841 respondents (79 percent), while 249 (24 percent) of the total sample thought that asthma was treated with AS. Most (872 or 82 percent) felt that their knowledge about AS was inadequate and 700 (66 percent) were of the opinion that AS should be banned from use in competition. Similarly, 733 (70 percent) of the gym users thought AS should be available only by prescription. Thirty respondents reported having used AS (2.9 percent, 95 percent CI 2.0-4.1) and the prevalence of AS use was higher among males than females (X = 13.28, p<0.001, df = 1). Improvement of physical appearance was one of the main reasons cited for AS use. AS users knew more about the adverse effects of AS than non-AS users. However, the therapeutic uses of AS were comparatively less well known amongst both AS and non-AS gym-users. This study demonstrates a lack of knowledge about AS among the gym users and a prevalence of AS use of 2.8 percent which may be an underestimation due to the self-reporting nature of the questionnaire.(AU)

Re-evaluation of diagnostic uterine dilatation and curettage: a review of 203 patients

Two handred and three patients were reviewed to assess the efficacy of diagtnostic uterine dilatation and curettage. Thirteen (6.4%) had definitive pathological changes of the endometrium; of the 4 patients with endometrial carcinoma, 3 presented eith post-menopausal bleeding. Anaemia was present in 11/3% of those with menorrhagia. The complication rate was 3.4% and the mean hospital stay, 3 days. It is suggested that in pre-menopausal women with abnormal uterine bleeding, medical management and outpatient endometrial biopsy should be the preferred diagnostic approach. fora post-menopausal women, curettage under general anaethesia remains the diagnostic method of choice