The ageing of the population - a time for action: the role of public health

The past two decades have witnessed the growth of the over-60,"elderly" population both in numbers and life expectancy. Similarly, there has been a shift in overall morbidity from acute to chronic causes and associated lifestyle factors. The increasing elderly population provides health care planners with new challenges at a time of decreasing resources. The public health approach, which equally stresses the responsibility of the individual, the family, the community and health care providers, is suggested as the starting point for addressing the issue. (AU)

The ageing of the population - a time for action: the role of public health

The past two decades have witnessed the growth of the over-60,"elderly" population both in numbers and life expectancy. Similarly, there has been a shift in overall morbidity from acute to chronic causes and associated lifestyle factors. The increasing elderly population provides health care planners with new challenges at a time of decreasing resources. The public health approach, which equally stresses the responsibility of the individual, the family, the community and health care providers, is suggested as the starting point for addressing the issue.

Prevalence of exercise-induced asthma in schoolchildren in Kingston, St. Andrew and St. Catherine, Jamaica

A cross-sectional study was done, focusing on the prevalence of exercise-induced asthma in Jamaica and variables that may account for this rate. No previous study of this nature had been undertaken, and the investigators contend that there is a need to identify children who suffer from this condition but are unaware of it. A sample of 214 students from primary and secondary schools in the corporate area were chosen and given questionnaires to complete. Eighty-four of the children reported a history consistent with that of exercise-induced asthma and were further subjected to stress testing for a definitive diagnosis of this condition. A prevalence of 20.8 percent [C.I ñ 5.35] was identified which reflected a rate comparable to that recorded in North America. There was a significantly higher prevalence in children of primary school ages, but all other variables considered for significance testing to determine associations between these and the prevalence of EIA proved not significant. A recomendation has been made for opportunity screening by medical practitioners (AU)

Prevalence of exercise-induced asthma in schoolchildren in Kingston, St. Andrew and St. Catherine, Jamaica

A cross-sectional study was done, focusing on the prevalence of exercise-induced asthma in Jamaica and variables that may account for this rate. No previous study of this nature had been undertaken, and the investigators contend that there is a need to identify children who suffer from this condition but are unaware of it. A sample of 214 students from primary and secondary schools in the corporate area were chosen and given questionnaires to complete. Eighty-four of the children reported a history consistent with that of exercise-induced asthma and were further subjected to stress testing for a definitive diagnosis of this condition. A prevalence of 20.8 per cent [C.I ñ 5.35] was identified which reflected a rate comparable to that recorded in North America. There was a significantly higher prevalence in children of primary school ages, but all other variables considered for significance testing to determine associations between these and the prevalence of EIA proved not significant. A recomendation has been made for opportunity screening by medical practitioners

Casualty transit time for 100 adult walk-in patients at the University Hospital of the West Indies

The Casualty Department of the University Hospital of the West Indies (UHWI) has evolved in an ad hoc manner over the last decade, and questions regarding its appropriateness and effectiveness as an emergency department persist. This study of 100 systematically-selected patients attempts to assess time utilization during transit, as dictated by the present system of patient management. Time to first contact averaged 2 hr 38 min (158 min). The mean total time was 3 hr 46 min (226 min) and mean total waiting time was 3 hr 10 min (190 min), versus a mean total utilized time of 19 min. Actual contact time withcasualty officers averaged only 8.3 min. Referrals to specialist services constituted 11 percent of the sample, and overall mean waiting time for specialists was 2 hr16 min (136 min) with a mean contact time of 48 min. Given that the mean total time of 3 hr 46 min is not inordinately long in a public health health system such as ours, the recommendation is being made for a modified coding and triage system to reduce time to first contact for more urgent cases (AU)

Feasibility of integrating community psychiatric services into primary health care facilities in Belize: a preliminary report

Paper states that the inception of a new Psychiatric Nurse Practitioner's Programme at the Belize School of Nursing in 1990 signalled the phasing out of the existing outreach program to rural districts. In its place would be a community-based psychiatric service headed by Psychiatric Nurse Practitioners deployed to district work stations. This study aimed at exploring the readiness of members of the health services previously involved to accept the impending change in psychiatric service delivery and to assess the extent of integration of community mental health at this time. In August of 1991, a self-administered questionnaire was issued to psychiatric service delivery personnel, both form primary and secondary care, and structured interviews were carried out with senior administrators in Belize. The results indicate a high level of basic training and a notable degree of integration already existing within the system. The vast majority of primary and secondary care respondents appeared willing to accept the new category of worker into the system, and both groups were also willing to participate in routine care of the mentally ill, especially if trained to do so. The administrators' responses hinted at a lack of cohesiveness among this group regarding achievement of policy objectives. In view of these findings, a forum for review of and forward planning for the psychiatric services in Belize would be welcome at this time(AU)

Morbidity pattern of emergencies at the Bustamante Hospital for Children (January-December, 1986)

A one-year retrospective study of paediatric emergencies seen at the Bustamante Hospital for Children for the period January 16 to December 31, 1986 is presented. Thirty-four per cent (3,918) of a total of 11,495 patients seen in the Casualty Department for 100 randomly selected days were assessed as emergencies. The most frequently seen emergencies were gastroenteritis (42.55 percent of total emergencies) followed by bronchial asthma (23.0 percent) and shortness of breath (16.51 percent). The rigid classification of emergencies by disease category needs to be reappraised (AU)