Postcolonial nursing education in Trinidad and Tobago

In this article the impact of the developed nations on basic nursing education in Trinidad and Tobago in the postcolonial period is discussed and analyzed. Subsequent to self-government in 1956, the national government, in its efforts to become independent of its reliance on Great Britain, turned to the United States and Canada for technical and financial aid. Consequently, sources such as the World Bank, Inter-American Development Bank, Pan American Health Organization/World Health Organization, and the Canadian International Development Agency were major avenues for the provision of ideas, concepts, and values in health planning and policy making with primary health care endorsed by the government. Nursing education was thus influenced by these industrialized concepts and values. The impact of socioeconomic and nursing events in the Caribbean region coupled with local initiatives taken by the indigenous leadership to improve nursing education resulted in a program that was an amalgamation of British, North American, and indigenous features.     

Attitudes towards blood donation in Trinidad and Tobago

summary .  The aims of this study were to determine the factors that influence blood donation in different demographic groups in a multi-ethnic, multicultural community, and to devise a strategy for a national campaign to increase voluntary non-remunerated blood donations.
The majority (87%) of blood donations in Trinidad and Tobago are replacement donations. Seventy per cent of the country's transfusion needs are not met. In 1998, the World Health Assembly recommended that reliance on replacement donations should be phased out due to their association with an increased risk of transfusion-transmitted infections.
An observer-administered questionnaire was completed by 1423 respondents in a multi-ethnic borough in central Trinidad. Respondents were classified as donors or non-donors and grouped by age, race, religion, employment status and highest level of education. The prevalence of a history of blood donation and the factors that encouraged donation or conversely discouraged donation in each demographic group were recorded.
A total of 1146 (81·2%) respondents had never donated blood. Of the 277 (18·8%) who had previously donated, replacement for a family member or friend was the most common reason (86·9%). The prevalence of donation was low in all racial, religious, gender, educational and age groups. However, there were significant demographic variations. The majority (71·3%) of non-donors cited a lack of information as a major reason for non-donation and expressed a willingness to donate if access to information and donation facilities were improved.
Voluntary blood donation in Trinidad and Tobago could be greatly increased by a national education campaign and increased accessibility to donation centres. This would ensure a safer and more reliable blood supply.     

Colonial Heritage and Nursing Leadership in Trinidad and Tobago

The present report analyzes the development of indigenous nursing leadership in Trinidad and Tobago within a political and economic context. Psychological and administrative factors inherited from the nation's colonial past persisted in the postindependence period (1956-1986). Discussed in the report are political and economic factors that both promoted and hindered the development of indigenous nursing leadership as well as international nursing perspectives that have relevance to the issue.     

The quality of medical laboratory practice in Trinidad and Tobago, West Indies

The introduction of automated chemical analyzers in the laboratory service has the potential of adversely affecting professionalism in laboratory practice. The present study assesses the quality of medical laboratory technicians in Trinidad and Tobago using structured questionnaires. Some of the critical questions included job status, years of experience, training, qualification(s) and knowledge of quality assurance and its application. About 82% of laboratory technicians responded to the study. The majority of technicians (62%) had diploma certificates while only one (1.2%) had a postgraduate degree. Although the majority (91.7%) of technicians knew about quality assurance, 36% learnt on the job and 59% knew they were not professionally trained. The results showed that there is paucity of highly trained laboratory technicians in Trinidad and Tobago and this has significant implications on the technical initiative and quality of medical laboratory practice in this country. We recommend the establishment of appropriate professional institutions for training medical laboratory technologists and regular expert inspection and accreditation of all medical laboratories in the country.     

Blood transfusion in the Caribbean: a case study of Trinidad and Tobago

The Caribbean islands form an archipelago connecting North and South America. They have all been colonised by European countries and share strong historical, social, economic and diplomatic links with North America. However, their blood transfusion services have evolved differently, using predominantly family/replacement rather than voluntary non‐remunerated donors as has been the practice in England and America since 1926 and 1970, respectively. This article uses the case of Trinidad and Tobago to examine the history and current state of blood transfusion services in the Caribbean and to present early results of an initiative for improving blood safety and adequacy in the region.     

Evaluation of blood donor deferral causes in the Trinidad and Tobago National Blood Transfusion Service

summary . The majority of blood donations in Trinidad and Tobago are made as replacement by family members or friends. National Blood Transfusion Policy was drafted in 2007 to promote voluntary, repeated donation. The objective of this study is to assess the current rate and reasons for donor deferral, and the aim is to guide the proposed donor education and recruitment programme. A retrospective study of pre-donation deferral of prospective blood donors at the National Blood Transfusion Centre, Port of Spain, Trinidad and Tobago, was conducted. Records of all pre-donation deferrals over a 12-month period were studied. As many as 11 346 pre-donation screening interviews were conducted. There were 4043 (35.6%) deferrals. The most common reasons for donor deferral were exposure to high-risk sexual activity (27.6%), low haemoglobin 22.2% and hypertension 17.5%. Other reasons such as medication, chronic medical illness, tattoos, travel history, recent pregnancy, surgery or presentation outside the accepted age limit caused 33.8% of all deferrals and the majority (34.7%) of male deferrals. Low haemoglobin (44.5%) was the most common reason among females. The rate of deferral of voluntary donors was not significantly different from that for replacement donors (31.7 vs. 35.4%, P = 0.25). This study exposed a lack of public awareness as the principal reason for an unacceptably high rate of donor deferral. Donor education about selection criteria needs to be urgently addressed as an objective of the National Policy. Monitoring and evaluation of deferral rates and reasons could be used as one indicator of the effectiveness of the Policy.     

Small Islands, Big Problem: HIV/AIDS and Youth in Trinidad and Tobago

PROBLEM: In the Caribbean region, women and young girls are becoming infected with HIV at a 6:1 rate more than men. Our study investigated effective methods for reducing HIV/AIDS risks among adolescent girls in the Caribbean. METHODS: One hundred females, aged 15-21, were randomly assigned into a control or intervention group. Subjects were assessed at baseline and postintervention. FINDINGS: Analysis of variance revealed that items measuring feelings about self, perceived risk, and sexual attitudes had statistically significant postintervention increase. CONCLUSION: Sustainable HIV/AIDS prevention programs that address stigma, promote HIV testing, and reinforce safer sex practices are needed.     

Parental perceptions of barriers to physical activity in children with developmental disabilities living in Trinidad and Tobago

Abstract

Background: Parents have a strong influence on their child’s engagement in physical activities, especially for children with developmental disabilities, as these children are less likely to initiate physical activity. Knowledge is limited regarding parents’ perceptions of this phenomenon in low- and middle-income countries (LMICs); yet many rehabilitation providers work with children with developmental disabilities and their parents in these contexts. Purpose: The aim of this study was to explore the barriers perceived by parents of children with developmental disabilities to their children’s engagement in physical activity. Methods: An occupational perspective was used to explore how parents speak about barriers to their child’s engagement in physical activity. Interviews were conducted with nine parents in Port-of-Spain, Trinidad and Tobago. Findings: Parent’s perceived barriers were categorized into four themes: family priorities, not an option in our environment, need to match the activity to the child’s ability, and need for specialized supports. Conclusions: Findings provide opportunities for future rehabilitation and community programming in LMICs.

• Implications for Rehabilitation

• Children living with a developmental disability may engage more in solitary and sedentary pursuits as a result of parents choosing activities that do not present extensive social and physical demands for their child.

• Therapists can play an important role in providing knowledge to parents of appropriate physical activity and the benefits of physical activity for children with developmental disabilities in order to promote children’s participation.

• In environments where there is limited social support for families, therapists need to consider and be particularly supportive of parental priorities and schedules.

     

Management of hypothyroidism and hyperthyroidism in the intensive care unit

Thyroid storm and myxedema coma are uncommon problems in the ICU, but both usually present with typical findings, and when recognized early, are treatable. Thus, rapid recognition with early institution of therapy may be life saving. It is always important to search diligently to determine the underlying cause of the decompensation and to treat that aggressively.     

甲状腺功能亢进性心脏病的围术期处理

目的探讨甲状腺功能亢进（甲亢）性心脏病的围术期处理的方法与效果。方法对98例甲亢性心脏病围手术期的处理措施和效果结合文献进行分析总结。结果98例经充分术前准备和精确的心功能评估达手术要求,再配合术中恰当的麻醉、轻柔快捷的手术、合理的术后处理,本组除1例中止手术外,其余均顺利完成手术,围术期无心血管并发症出现。结论甲亢性心脏病并非甲亢手术的禁忌证,A-B级心功能下进行手术是安全的。     

妊娠与甲亢

甲状腺功能亢进症（hyperthyroidism）简称甲亢,是由于甲状腺激素分泌增加而导致的高代谢和交感神经系统兴奋性增加引起一系列临床表现。近年来由于加碘盐的普及使用,甲亢发病率呈逐年升高趋势。由于其好发于育龄女性,因此妊娠是甲亢不可回避的一个问题。     

1例血色病合并亚临床甲状腺功能亢进病人的管理

血色病是指肝脏、胰腺、心脏和其他器官大量铁沉积,导致器官功能损害和结构破坏的疾病.该病好发于中年男性,男女之比约8∶1[1].肝是最早和最严重的铁聚集部位.反复放血排出体内的铁是此病最有效、最经济的治疗方法[2].血色病合并亚临床甲状腺功能亢进临床上很罕见,2010年10月我科收治1例此病病人,经积极纠正心力衰竭、放血治疗、抗甲状腺治疗及耐心管理疗效满意.现将护理介绍如下.     

Changing types of nephritogenic streptococci in Trinidad

The relation of seven different M types of streptococci to acute glomerulonephritis associated with skin lesions in South Trinidad has been studied by means of type-specific antibody assays as well as by isolation and identification of the strains. The data indicate that, one after another, five of these strains have prevailed among patients with acute glomerulonephritis during the past five years. At least three of the strains (M-types 55, 49, 57, and/or 60) were associated with epidemic increases in nephritis cases. The appearance of five consecutively predominant types of nephritogenic streptococci during a relatively short period of time is in contrast to the continuing prevalence of M-type 12 strains among nephritogenic streptococci primarily associated with respiratory infections in temperate zones. These observations suggest that the skin sores commonly found on children in tropical Trinidad, provide a particularly suitable environment for development of nephritogenic types. It remains to be seen whether these types will recur or whether new types will continue to emerge in Trinidad.