W Indian Med J
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Randomized Controlled Trial Multicenter Study
Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2) A randomised, placebo-controlled trial.
Tranexamic acid can reduce bleeding in patients undergoing elective surgery. We assessed the effects of early administration of a short course of tranexamic acid on death, vascular occlusive events, and the receipt of blood transfusion in trauma patients. ⋯ Tranexamic acid safely reduced the risk of death in bleeding trauma patients in this study On the basis of these results, tranexamic acid should be considered for use in bleeding trauma patients.
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Multicenter Study
Knowledge, perception and practices of healthcare professionals at tertiary level hospitals in Kingston, Jamaica, regarding neonatal pain management.
To determine knowledge, perception and practices of healthcare professionals at tertiary level hospitals in Kingston, Jamaica, regarding neonatal pain management. ⋯ There is an overwhelming deficiency in the knowledge, perception and practice of neonatal pain management at tertiary level institutions in Kingston, Jamaica. There is the urgent need for the education of health professionals on neonatal pain management. This will in turn facilitate change in perception and eventually, along with the institution of local policies and protocols, influence practice.
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Randomized Controlled Trial Multicenter Study
Field trial to test and evaluate primary tobacco prevention methods in clusters of elementary schools in Barbados.
To evaluate methods of preventing young children from experimenting with tobacco and to determine cost effectiveness, students (n = 1005) in 31 primary schools, from randomly selected higher grade-levels were recruited into a partially randomized, single blinded controlled trial in which seven groups of schools were randomly assigned to a combination of teaching, leaflet, and drama, in order to modify students' knowledge, attitudes, beliefs and behaviour (KAB). The eighth group (n = 346) with ten schools, distantly separated from the former, was assigned to be the control, but was dropped from comparison analysis for lack of randomness at baseline. The mean, standard deviation and median age of the intervention groups was 9.94 years (0.81), 10.0 years, (n = 669) at baseline; and 10.62 years (0.66), 11.0 years, (n = 397), at 12 months follow-up. ⋯ Teaching health education at school when combined with other methods was significantly better at improving KAB. In 2003, after a year post-intervention, the occurrence of experimentation smoking in the last 30 days, dropped from 9.2% to 1.2% (p = 0.00), equivalent to 87% (95% CI 78, 93) reduction in the group exposed to health education compared to none in the leaflet-only group and Numbers Needed to Treat (NNT) = 12.5. Due to its cost-effectiveness (comparable to child immunizations) at BDS dollars 1.89 to 2.89 or US dollars 1 to 1.5 per child contacted and BDS dollars 100 to 140 (US dollars 50 to 70) capital investment in other resources per school, the experience could be utilized routinely in elementary schools.
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Multicenter Study
Paediatric HIV/AIDS in Jamaica. A hospital-based description.
The continuing worldwide epidemic of adult HIV/AIDS has led to an increase in the number of HIV-positive children mainly through perinatal transmission. Although national data are available, there is no published report of the epidemiology of HIV/AIDS in children in Jamaica. A multicentre retrospective analysis of 183 HIV seropositive children admitted to hospitals in Jamaica between 1990 and 1996 was conducted. ⋯ From these data, it is estimated that the hospital-based HIV incidence among children in Jamaica increased from 0.149 per 10,000 person years in 1990 to 1.331 per 10,000 person years in 1996. This study demonstrates a rise in the estimated incidence of HIV/AIDS but we were unable to estimate survival reliably since the data required were not available for 75% of children identified. These data highlight the urgent need for targeted interventions to reduce vertical transmission of HIV as well as a need for prospective studies to establish reliable data on incidence and long-term outcome for HIV-infected children.