Marijuana use and its influence on sperm morphology and motility: identified risk for fertility among Jamaican men.

BACKGROUND: The growing international movement legislating medical marijuana has brought renewed interest to the role of marijuana smoking on fertility potential. Although studies have identified that sperm quality can be compromised by marijuana use, little focus has been placed specifically on those trying to conceive. In this study, we aimed to clarify the impact of marijuana use in semen quality in men being investigated for assisted reproduction. MATERIALS AND METHODS: We conducted a cross-sectional study at a university-based facility in Jamaica. Routine semen analyses were performed on 229 men ages 23-72 years who were new clients. Logistic regression analyses were performed in order to independently predict quantifiable measures of the impact of marijuana use. The main outcome measures were sperm motility, total motile spermatozoa and morphology. RESULTS: Overall, 47% of the participants reported marijuana use with 21% of these men reporting recent use. Regression analyses showed that recent use and users of large quantities of marijuana were 2.6 times (aOR = 2.6; 95% CI, 1.0-6.8, p = 0.044) and 4.3 times (aOR = 4.3; 95% CI, 1.1-15.9, p = 0.030) at greater risk of being diagnosed with abnormal motility (asthenozoospermia). Additionally, moderate quantity users were 3.4 times (aOR = 3.4; 95% CI, 1.5-7.9, p = 0.004) more likely to be diagnosed with abnormal morphology (teratozoospermia). DISCUSSION AND CONCLUSION: Recent use of marijuana as well as moderate to large quantities had an impact on sperm motility and morphology in men being investigated for infertility. We recommend therefore that men undergoing fertility investigations be routinely asked about their recreational use of marijuana and in particular recent and heavy users counselled to stop.

Male attitude towards masturbating: an impediment to infertility evaluation and sperm parameters.

Male attitude about masturbation may influence early diagnosis and treatment of infertility and may be of particular burden in developing countries. We sought to explore attitude about masturbating and examine comfort/discomfort with masturbating and sexual history, pregnancy history and sperm quality in men investigating fertility potential. The study consisted of 83 male volunteers, 23-61 years, attending a fertility management unit in Kingston, Jamaica. Comfort with masturbation was assessed by a self-administered questionnaire. Participants also completed the unit's standard intake form for infertility investigations and produced a semen sample. T-tests, Mann-Whitney U-test and chi-square were used to compare differences in comfort level with outcome variables. We found 59% were comfortable masturbating although requiring external stimulation to produce a sample (48%); 6% (n = 5) failed to produce a sample after repeated attempts. A higher percentage of men uncomfortable with masturbating reported sexual problems (P < 0.05) and spending a longer time trying to have a baby (P < 0.05). Semen quality was not associated with masturbating comfort. Producing a sample by masturbation is standard for many assisted conception treatments. As comfort with masturbating may influence delay in infertility investigations and fertility outcome, efforts to improve men's comfort level with semen production should be considered in pre-treatment fertility counselling.

Children's exposure to violence in Jamaica: over a decade of research and interventions.

Many children in Jamaica are exposed to violence of various forms in settings where they should be protected, namely, their homes, schools and communities. Schools in particular which were once seen as safe havens have been in the media with reports of student on student violence, student on teacher violence, teacher on student violence and community on school violence. This paper presents research findings over the last 15 years out of The University of the West Indies (UWI), Mona, Jamaica on the nature and prevalence of violence exposure, outcomes and associated risk and protective factors. It also highlights psychologically-driven interventions and policy papers addressing violence exposure coming out of the Department of Child and Adolescent Health, UWI, Mona, during the past decade.

Evolution of in vitro fertilization at the University of the West Indies, Jamaica.

In vitro fertilization (IVF) provides hope for many couples who believed that they could not have children. This paper tracks the development of IVF treatment at The University of the West Indies (UWI), Mona, from its genesis in 2000. It highlights changes over the years in the population seeking IVF at UWI, Mona, and describes clinical services offered to clients, comparing success rates of services internationally. It also reports on seminal research emerging out of UWI, Mona, in the field of assisted reproductive health. The Hugh Wynter Fertility Management Unit (HWFMU), UWI, Mona, leads the way in shaping how society views those challenged with infertility and in its use of assisted reproductive technologies that improve the quality of life for many locally, within the Caribbean and the Diaspora.

Students admitted to university who fail: hidden disabilities affecting students' performance.

OBJECTIVE: To compare grade point averages and social adjustment and academic difficulties of students with or without a hidden disability at The University of the West Indies, Mona, Jamaica. METHODS: Comparison groups were identified through The University of the West Indies (UWI) Health Centre, peer-counselling training programme and an undergraduate class. The 165 participants completed a checklist on health, social and academic concerns and provided a copy of their transcripts. Students were screened for hidden disabilities including attention deficit hyperactivity disorder (ADHD) and psychiatric morbidity. RESULTS: Students with hidden disabilities consistently performed poorer academically than their non-disabled peers, and students with ADHD performed the worst. The high levels of distress common to students with a hidden disability may explain the difference in performance between them and non-disabled students. Students'ability to manage their time, irrespective of having a disability, was singled out as important for obtaining good grades. CONCLUSIONS: Potentially brilliant students are at risk of failing out of university because of hidden disabilities and the associated emotional and social challenges.

Gender differences in coping with infertility among couples undergoing counselling for In Vitro Fertilization treatment / Diferencias de género a la hora de enfrentar problemas de esterilidad entre parejas que reciben consejería para el tratamiento de fertilización in vitro

OBJECTIVE: To identify gender differences in coping responses and the association between coping and psychological distress in couples undergoing In Vitro Fertilization (IVF) treatment at the University of the West Indies (UWI). METHODS: All men and women (n = 52) who were offered psychological counselling prior to beginning IVF treatment between October 2003 and May 2004 were invited to complete questionnaires on their coping responses, self-reported distress and socio-demographic data. One female declined. RESULTS: Of the 51 participants, 52had completed secondary education, 44tertiary education, and 37were 38 years or older; 42of the couples were trying for more than seven years to have a child. Gender differences in coping included more women than men keeping others from knowing their pain (p < 0.01) and more women ruminating about what they did wrong to cause the infertility (p < 0.01). These strategies were also associated with reports of heightened distress (p < 0.05). Talking to others to obtain information was associated with less negative feelings. Coping skills that were commonly used by both genders included seeking medical advice and engaging in wishful thinking. CONCLUSION: Women coping with infertility may be at risk for self-depreciation and isolation because of their choice of coping strategies and the meaning they ascribe to the infertility. As a result, they are likely to experience more heightened distress than men who are also infertile. Counselling that is specific to gender-needs is indicated.

OBJETIVO: Identificar las diferencias de género en las respuestas de enfrentamiento, y la asociación entre la angustia (distrés) del enfrentamiento y la angustia psicológica en las parejas que reciben tratamiento de fertilización in vitro (FIV) en el Hospital Universitario de West Indies. MÉTODOS: A todos los hombres y mujeres (n = 52) a quienes se les ofreció consejería psicológica antes de comenzar el tratamiento de FIV entre octubre de 2003 y mayo de 2004, se les invitó a llenar cuestionarios sobre sus respuestas de enfrentamiento, auto-reporte de su angustia, y datos socio-demográficos. Una mujer rechazó la encuesta. RESULTADOS: De los 51 participantes, 52% habían terminado su educación secundaria, 44% la educación terciaria, y 37% tenían 38 años o más, en tanto que el 42% de las parejas había estado tratando de tener un hijo o hija por más de siete años. Las diferencias de género al enfrentar el problema de la infertilidad incluían más mujeres que hombres en cuanto a evitar que otros supieran del dolor (p < 0.01) y más mujeres rumiando que habrían hecho mal que provocó la esterilidad (p < 0.01). Estas estrategias estuvieron también asociadas con reportes de intenso distrés (p < 0.05), mientras que el hablar a otros para obtener información estuvo asociado con sentimientos menos negativos. Las habilidades de enfrentamiento usadas comúnmente por ambos géneros incluían la búsqueda de consejo médico y el juego a hacerse ilusiones. CONCLUSIONES: En su enfrentamiento al problema de la esterilidad, las mujeres pueden correr el riesgo de la auto-depreciación y el aislamiento debido a su elección de estrategias de enfrentamiento, y al significado que adscriben a la esterilidad. A consecuencia de ello, es probable que experimenten angustia con más intensidad que los hombres estériles. Se indica que la consejería debe realizarse en correspondencia con las necesidades específicas de cada género.

Gender differences in coping with infertility among couples undergoing counselling for In Vitro Fertilization treatment.

OBJECTIVE: To identify gender differences in coping responses and the association between coping and psychological distress in couples undergoing In Vitro Fertilization (IVF) treatment at the University of the West Indies (UWI). METHODS: All men and women (n = 52) who were offered psychological counselling prior to beginning IVF treatment between October 2003 and May 2004 were invited to complete questionnaires on their coping responses, self-reported distress and socio-demographic data. One female declined. RESULTS: Of the 51 participants, 52% had completed secondary education, 44% tertiary education, and 37% were 38 years or older; 42% of the couples were trying for more than seven years to have a child. Gender differences in coping included more women than men keeping others from knowing their pain (p < 0.01) and more women ruminating about what they did wrong to cause the infertility (p < 0.01). These strategies were also associated with reports of heightened distress (p < 0.05). Talking to others to obtain information was associated with less negative feelings. Coping skills that were commonly used by both genders included seeking medical advice and engaging in wishful thinking. CONCLUSION: Women coping with infertility may be at risk for self-depreciation and isolation because of their choice of coping strategies and the meaning they ascribe to the infertility. As a result, they are likely to experience more heightened distress than men who are also infertile. Counselling that is specific to gender-needs is indicated.

Suicidal behaviour and risk factors in children and adolescents in Jamaica.

Suicidal attempts and ideation were examined in children attending child and adolescent mental health clinics in the Kingston Metropolitan Area during October 1998 to September 1999. The case records of fifty-seven 6-18 year-olds were selected for review in order to identify social and familial factors that place Jamaican children and adolescents at risk for suicidal behaviour. In addition, in order to examine the consistency of risk factors, data from child and adolescent mental health clinics were compared over a ten-year period between 1989 and 1999. The results indicated that having a poor relationship with the primary caregiver was significantly associated with suicidal behaviour (p < 0.01) as well as experiencing abuse (p < 0.05). These children also tended to externalize their behaviours (p < 0.01). The findings suggest that, over the ten-year period, Jamaican children seem to be more readily talking about, contemplating and attempting, suicide. The importance of managing intrafamilial issues affecting children is highlighted.

Suicidal behaviour and risk factors in children and adolescents in Jamaica

Suicidal attempts and ideation were examined in children attending child and adolescent mental health clinics in the Kingston Metropolitan Area during October 1998 to September 1999. The case records of fifty-seven 6-18 year-olds were selected for review in order to identify social and familial factors that place Jamaican children and adolescents at risk for suicidal behaviour. In addition, in order to examine the consistency of risk factors, data from child and adolescent mental health clinics were compared over a ten-year period between 1989 and 1999. The results indicated that having a poor relationship with the primary caregiver was significantly associated with suicidal behaviour (p < 0.01) as well as experiencing abuse (p < 0.05). These children also tended to externalize their behaviours (p < 0.01). The findings suggest that, over the ten-year period, Jamaican children seem to be more readily talking about, contemplating and attempting, suicide. The importance of managing intrafamilial issues affecting children is highlighted

Children's response to hospitalization at the University Hospital of the West Indies.

The results of this study indicated that patients aged 3-13 years who had a history of previous hospitalization appeared to be significantly more distressed than patients without such previous history (p < 0.05). Previously hospitalized children were more uncooperative and displayed anxious, immature behaviour patterns. Children who were hospitalized for more than a month were also interviewed about their concerns and response to hospitalization. The study highlighted the need for hospitalized children to be better prepared for hospitalization, to have greater parental involvement in the management of their behaviour and to have efficiently run programmes geared at addressing their educational and emotional needs.

Autism in Jamaica.

This paper reviews childhood autism, a serious psychopathological disorder, with emphasis placed on aetiology and management; and outlines briefly the care of the autistic population in a few well organized programmes existing in Jamaica. There is a need for increased awareness, local research and dissemination of information to appropriate personnel and organizations.

Autism in Jamaica

This paper reviews childhood autism, a serious psychopathological disorder, with emphasis placed on aetiology and management; and outlines briefly the care of the autistic population in a few well organized programmes existing in Jamaica. There is a need for increased awareness, local research and dissemination of information to appropriate personnel and organizations.

Do relatives of terminally ill patients also benefit from hospice care?

An analysis was carried out on the extent to which staff responded to the relatives of cancer patients who had been admitted to the Consie Walters Hospice Care Centre, and the Pain Centre, both located in Kingston, Jamaica. Although no relationship was found between frequency of intervention and relatives' (caregivers') health, grief reactions were found to be related to a need for staff interaction. The more caregivers reported that they needed staff emotional support and practical assistance, the more intensely they reported grief, and the greater were their reports of anxiety and insomnia. Age was found to influence the relationship between adjustment and receiving intervention.

Do relatives of terminally ill patients also benefit from hospice care?

An analysis was carried out on the extent to which staff responded to the relatives of cancer patients who had been admitted to the Consie Walters Hospice Care Centre, and the Pain Centre, both located in Kingston, Jamaica. Although no relationship was found between frequency of intervention and relatives' (caregivers') health, grief reactions were found to be related to a need for staff interaction. The more caregivers reported that they needed staff emotional suport and practical assistance, the more intensely the reported grief, and the greater were their reports of anxiety and insomnia. Age was found to influence the relationship between adjustment and receiving intervention