W Indian Med J
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A number of studies attempting to identify specific risk factors for dementia have noted an inverse relationship between educational background and the likelihood of developing dementia. This idea has been somewhat controversial as educational background can introduce a number of confounding factors that generally affect health and lifestyle. Despite these reservations, there is mounting evidence to support the concept of education (or increased mental activity) producing a functional reserve in the brain, a process that provides some protection against the clinical manifestation of dementia. ⋯ We have shown recently that LTP reduces the sensitivity of hippocampal neurons to agonists of the neurotransmitter glutamate; additionally, we have reported that LTP protects the neurons from the effects of acute hypoxia. Given that the effect of hypoxia on neurons involves over-stimulation by glutamate, and hypoxia has been implicated in the aetio-pathology of some types of dementia, our observations suggest that LTP has a protective effect on neuronal tissue. Such an interaction offers a physiological basis for the epidemiological evidence that lifelong learning can protect a person from some types of dementia.
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The high incidence of trauma in Jamaica is well documented. Trauma accounts for approximately 40 per cent of the workload in both the Accident and Emergency Unit and the surgical wards at the University Hospital of the West Indies. The death rates for motor vehicle accidents and homicide in Jamaica are greater than those in developed countries as well as the rest of the Caribbean region. ⋯ In hospitals, most preventable deaths occur within the first few hours of admission. An organized system of care which ensures that the right patient is taken to the right hospital at the right time as well as training in Advanced Trauma Life Support should reduce the preventable death rate. Collaboration is needed between health workers and other concerned groups to stimulate an interest in injury prevention and improvement in trauma care.