Perceptions and experiences of violence among secondary school students in urban Jamaica.

OBJECTIVE: To obtain information on the perceptions and experiences of violence among secondary school students in Kingston, Jamaica, and its environs. METHODS: Data collection was carried out from September through December 1998. Two researchers administered questionnaires in 11 randomly selected secondary schools, to a total of 1 710 students who were in either grade 7 or grade 9 and who were aged 9-17 years old (mean of 13.2 years). Frequency distributions of the responses were compared by gender, age, grade level, socioeconomic status, and school type. RESULTS: Seventy-five percent of the students thought that someone who was reluctant to fight would be "picked on" more, 89% thought it generally wrong to hit other people, and 91% thought it wrong to insult other people. Eighty-four percent knew of students who carried knives or blades from such items as a scalpel or a utility knife to school, and 89% were worried about violence at school. Thirty-three percent had been victims of violence, and 60% had a family member who had been a victim of violence. Eighty-two percent thought that violent television shows could increase aggressive behavior. Factor analysis of selected responses was carried out, yielding five factors: neighborhood violence, school violence, perceptions of acceptable behaviors, level of concern about violence, and general experiences and perceptions of violence. The factors varied with gender, age, grade level, socioeconomic status, and school type. CONCLUSIONS: These results will help focus interventions aimed at reducing violence, provide a baseline for later comparisons of perceptions and experiences of violence, and offer a basis for comparing the experiences of young people in urban Jamaica with those of young persons elsewhere.

Perceptions and experiences of violence among secondary school students in urban Jamaica

Objective. To obtain information on the perceptions and experiences of violence among secondary school students in Kingston, Jamaica, and its environs. Methods. Data collection was carried out from September through December 1998. Two researchers administered questionnaires in 11 randomly selected secondary schools, to a total of 1,710 students who were in either grade 7 or grade 9 and who were aged 9-17 years old (mean of 13.2 years). Frequency distributions of the responses were compared by gender, age, grade level, socioeconomic status, and school type. Results. Seventy-five percent of the students thought that someone who was reluctant to fight would be "picked on" more, 89 percent thought it generally wrong to hit other people, and 91 percent thought it wrong to insult other people. Eighty-four percent knew of students who carried knives or blades from such items as a scalpel or a utility knife to school, and 89 percent were worried about violence at school. Thirty-three percent had been victims of violence, and 60 percent had a family member who had been a victim of violence. Eighty-two percent thought that violent television shows could increase aggressive behavior. Factor analysis of selected responses was carried out, yielding five factors: neighbourhood violence, school violence, perceptions of acceptable behaviors, level of concern about violence, school violence, and general experiences and perceptions of violence. The factors varied with gender, age, grade level, socioeconomic status, and school type. Conclusions. These results will help focus interventions aimed at reducing violence, provide a baseline for later comparisons of perceptions and experiences of violence, and offer a basis for comparing the experiences of young people in urban Jamaica with those of young persons elsewhere (AU)

Perceptions and experiences of violence among secondary school students in urban Jamaica / Percepciones y experiencias en torno a la violencia en estudiantes de secundaria en la zona urbana de Jamaica

OBJECTIVE: To obtain information on the perceptions and experiences of violence among secondary school students in Kingston, Jamaica, and its environs. METHODS: Data collection was carried out from September through December 1998. Two researchers administered questionnaires in 11 randomly selected secondary schools, to a total of 1 710 students who were in either grade 7 or grade 9 and who were aged 9-17 years old (mean of 13.2 years). Frequency distributions of the responses were compared by gender, age, grade level, socioeconomic status, and school type. RESULTS: Seventy-five percent of the students thought that someone who was reluctant to fight would be "picked on" more, 89 percent thought it generally wrong to hit other people, and 91 percent thought it wrong to insult other people. Eighty-four percent knew of students who carried knives or blades from such items as a scalpel or a utility knife to school, and 89 percent were worried about violence at school. Thirty-three percent had been victims of violence, and 60 percent had a family member who had been a victim of violence. Eighty-two percent thought that violent television shows could increase aggressive behavior. Factor analysis of selected responses was carried out, yielding five factors: neighborhood violence, school violence, perceptions of acceptable behaviors, level of concern about violence, and general experiences and perceptions of violence. The factors varied with gender, age, grade level, socioeconomic status, and school type. CONCLUSIONS: These results will help focus interventions aimed at reducing violence, provide a baseline for later comparisons of perceptions and experiences of violence, and offer a basis for comparing the experiences of young people in urban Jamaica with those of young persons elsewhere.

Objetivo. Obtener información acerca de cuáles son las percepciones y experiencias en torno a la violencia de los estudiantes de secundaria en Kingston, Jamaica, y sus alrededores. Métodos. La recolección de datos tuvo lugar de septiembre a diciembre de 1998. En 11 escuelas secundarias elegidas aleatoriamente, dos investigadores administraron cuestionarios a un total de 1 710 estudiantes de séptimo o noveno grado entre las edades de 9 y 17 años (media de edad: 13,2 años). Las distribuciones de frecuencias de las contestaciones se compararon en función del sexo, la edad, el grado escolar, el estrato socioeconómico y el tipo de escuela del encuestado. Resultados. Setenta y cinco por ciento de los estudiantes opinaban que si uno no quiere pelear es más probable que sus pares lo acosen o se burlen; a 89% les parecía condenable pegarles a los demás, y 91% consideraban que es reprobable insultar a otros. Ochenta y cuatro por ciento de los encuestados conocían a estudiantes que llevaban cuchillos o navajas y 89% se sentían preocupados por la violencia en la escuela. Treinta y tres por ciento habían sido víctimas de actos violentos y 60% tenían algún pariente que también lo había sido. Ochenta y dos por ciento opinaban que los programas de televisión pueden empeorar la tendencia a comportarse de forma agresiva. Se efectuó un análisis factorial a partir de algunas respuestas y los factores identificados fueron cinco: la violencia en el vecindario, la violencia en la escuela, la percepción de que determinadas conductas son admisibles, el grado de preocupación por la violencia y las experiencias y percepciones generales que se tienen en torno a la violencia. Estos factores variaron en función del sexo, la edad, el grado escolar, el estrato socioeconómico y el tipo de escuela del encuestado. Conclusiones. Los presentes resultados ayudarán a focalizar adecuadamente las intervenciones encaminadas a reducir la violencia, proporcionarán la base para futuras comparaciones de las percepciones y experiencias de los jóvenes en torno a la violencia, y servirán para comparar las experiencias de la juventud en la zona urbana de Jamaica con las de la juventud en otros lugares

Mitral valve disease in West Indian children results of operative intervention at the University Hospital of the West Indies - abstract

Rheumatic carditis and its sequelae tend to run a severe course in West Indian children. The mitral valve is most commonly affected by the disease process, and children thus afflicted often need surgical intervention to provide adequate palliation. A retrospective study of all children under 13 years of age subjected to isolated mitral valve surgery at the University Hospital was undertaken to evaluate the results of the palliative operations performed. There were 15 males and 13 females in the study and their ages ranged from 6 to 12 years (mean 10 yrs.) The operations performed were closed mitral commissurotomy (1), open mitral commissurotomy (1), porcine xenograft mitral valve replacemnet (3), homograft mitral valve replacement 922) and failed porcine homograft (1). Eight patients died of acute cardiac failure within 4 weeks of operation (29 per cent mortality). Of the 20 children surviving operation, 8 died (29 per cent mortality) between 0.25 and 5 years, and the causes of death were congestive cardiac failure (2), following re-operation (3), and infective endocarditis (3). The remaining 12 patients are alive and well and their period of follow-up ranges from 1 to 8.3 years (mean 4.5 years). Clinical and investigative (electrocardiographic and echocardiographic) data indicates a satisfactory functional result following operation. Mitral valve disease complicating rheumatic carditis is frequently encountered at the University Hospital, and the results of surgical intervention have been shown to be satisfactory. Earlier re-operation, when indicated, and stricter criteria for operative intervention, could further improve the results of surgical palliation (AU)

Serum immunoglobulin levels in children with homozygous sickle cell disease

Serum immunoglobulin levels (IgA, IgG, and IgM) have been assayed in a representative sample of children (aged 1-7 years) with homozygous sickle cell disease and in age/sex-matched control children with a normal haemoglobin genotype, followed from birth in a prospective cohort study. In SS disease, significant elevation of IgA occurred from the age of two years and of IgG from the age of six years. IgM levels were not significantly different in the two genotypes. The mechanisms contributing to these changes in immunoglobulins are currently unclear as is their clinical significance.(AU)

Homograft mitral valve replacement in children, 1975-1978

Seventeen children, aged 6 to 12 years, were subjected to Homograft Mitral Valve Replacement (HMVR) for severe Mitral incompetence (MI) at the University Hospital during the period 1975 - 1978. The clinical and investigative data, duration of bypass, operative findings, and results of HMVR have been presented. It is concluded that HMVR is a satisfactory palliative procedure for severe MI in children. Pre-operative cardiac catheter measurements of pulmonary artery oxygen saturation (PASO2) < 50 percent, and or systolic pressure (PA systolic) >100mm Hg and/or left ventriclar end-diastolic pressure (LVEDP) . 20 mm Hg indicate the likelihood of a poor operative result. A more critical selection of patients for HMVR, including the above criteria, should decrease early operative mortality. Late operative mortality due to valve malfunction could possibly be decreased by early re-operation when optimal medical therapy is not successful (AU)

Pulmonary stenosis with intact ventricular septum, 1968 - 1978

Twelve cases of pulmonary stenosis with intact ventricular septum had correction of their defects using cardiopulmonary bypass. One patient of acute cardiac failure in the early postoperative period. There were no late deaths. The 11 late survivors are well. The majority (10 patients) were in NYHA grade 1 and there has been a significant reduction in right ventricular size as determined electrocardiographically (AU)

The development of cardiac catheterization at the University Hospital

Cardiac catheterisation at the University Hospital from 1967 to 1978 has been described, with an outline of its development over the years, the techniques used, the results obtained and the complications encountered. Six hundred and six patients were subjected to cardiac catheterisation. Morbidity was low and there was one death due to malignant hyperthermia complicating general anaesthesia (AU)

Severe acute rheumatic fever: recent trends in the severity of the disease - abstract

Acute rheumatic fever remains a common disease in Jamaica. Between August, 1973 and July, 1978, there was only one death recorded among children under 12 years admitted to the University Hospital of the West Indies with this disease. There were 38 - 48 annual admissions for the disease during this period. Between August, 1978 and July 1979, there were 26 admissions for rheumatic fever. Five of these children presented with an unusually severe form of acute rheumatic fever which led to a fatal outcome in four cases. Only one of these children had previous admissions for the disease and he had received no penicillin prophylaxis for the preceding four months. The only surviving child developed frank pulmonary oedema within a few hours of admission and required ventilation for 5 days. Post-mortem findings in 4 cases showed rheumatic pancarditis, oedema and congestion of the lung and congestion of the liver. Decline in the incidence and severity of acute rheumatic fever has been reported from several centres since the 1920s. These recent cases of severe acute rheumatic fever may represent an incidental clustering of cases or may indicate that the severity of the disease is increasing in this population (AU)

The interaction of alpha thalassaemia with SS disease

A group of patients with SS disease with red cell indices and Hb A2 levels intermediate between those of SS disease and sickle cell-beta o thalassaemia has been described. Globin chain synthesis in 20 of these subjects selected on the basis of low MCV values gave alpha/non-alpha chain ratios in the alpha thalassaemia range (0.62-0.94) compared to 20 age sex matched controls. The AS parents of these subjects with low MCV showed a greater prevalence of low Hb S concentrations (a feature of the interaction of alpha thalassaemia with the sickle cell trait) compared to controls. These data suggest that this group may represent a subpopulation of SS disease resulting from the interaction with alpha thalassaemia. (AU)

Comparison of haematological features of the ᧠and á+ thalassaemia traits in Jamaican negroes

Haematological characteristics have been compared in 29 subjects with heterozygous ᧠thalassaemia and in 33 subjects with heterozygous á+ thalassaemia, identified by the type of sickle-cell-á thalassaemia among close relatives, in a Jamaican Negro population. Total haemoglobin, MCV and MCH were significantly lower in the ᧠type but the level of Hb A2 was not significantly different. Individual values for MCV, MCH and Hb A2 in the 225+ type occasionally overlapped those in the normal population casting doubt on the adequacy of these criteria in identifying all cases of heterozygous á+ thalassaemia. The haematological differences are those which would be expected on theoretical grounds. The inability to confidently differentiate the two types of heterozygous á thalassaemia has implications for genetic counselling. The inability to distinguish heterozygous á+ thalassaemia from normals on any single haematological index suggests that surveys depending on estimations of Hb A2 or on MCV alone may have underestimated the prevalence of the á+ thalassaemia gene. (AU)