Exploring Notions of Resilience and Adaptability in the Context of Piloting a Mobile App for Risk Awareness During Covid-19

This paper explores notions of resilience and adaptability in the context of the design, development and pilot of a mobile phone application, COVID-Aware, for enhancing risk awareness during the COVID-19 pandemic. Through an interdisciplinary team approach, we explore the utilization of an information and communications technology platform in supporting resilience and wellbeing at the individual and collective levels among community members. The study integrated data models, that were developed in Jamaica to predict the risk of COVID-19, with existing epidemiological models developed for COVID-19 in different parts of the world. Participants’ perspectives on adapting to the use of the app on their mobile devices assisted with exploring ways to share visualisations of this data, and their views of adaptations to health protocols provided feedback for participatory development of the app. The use of the mobile application to support risk awareness, assessment and potential choices, and implications for resilience are discussed.</p

Redrawing the boundaries of the Cockpit Country, Jamaica

The Cockpit Country of Jamaica, by virtue of its very name, implies a region that is defined by its geophysical attributes. There have been many debates and contemporary arguments about the nature of the Cockpit Country, particularly in light of the current effort to have the region declared a National Park and United Nations World Heritage Site. However, most of these arguments are based on the rich biodiversity of the Cockpit Country, not on the dramatic scenery that exists in the place. The Cockpit Country is the world type area for cockpit karst landscapes, and represents an important region in comparing the different karst landscapes around the world and putting these areas in a genetic and geomorphological context. However, cockpit karst has never been clearly defined. This paper describes the research effort made to distinguish cockpit karst on the basis of its inherent topographic properties, and subsequently defines the extent of the Cockpit Country based on these characteristics. This will provide a clear geomorphological definition for the Cockpit Country, free from the ambiguities of anthropogenic or biological definitions of the landscape

Innovative Applications of Laser Scanning and Rapid Prototype Printing to Rock Breakdown Experiments

We present the novel application of two technologies for use in rock breakdown experiments, i.e. close-range, ground-based 3D triangulation scanning and rapid prototype printing. These techniques aid analyses of form-process interactions across the range of scales relevant to breakdown (micron-m). This is achieved through (a) the creation of DEMs (which permit quantitative description and analysis of rock surface morphology and morphological change) and (b) the production of more realistically-shaped experimental blocks. We illustrate the use of these techniques, alongside appropriate data analysis routines, in experiments designed to investigate the persistence of fluvially-derived features in the face of subsequent wind abrasion and weathering. These techniques have a range of potential applications in experimental field and lab-based geomorphic studies beyond those specifically outlined here

Socio-environmental exposures and health outcomes among persons with sickle cell disease.

There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits. Urban patients had a higher prevalence of significant pain crises (69.4% vs. 55.8%, p value<0.001) and respiratory events (21.2% vs. 14%, p value<0.001). Prevalence of leg ulcers did not vary between rural and urban patients but was higher in males than in females. Females also had lower odds of having respiratory events but there was no sex difference in history of painful crises. Persons with more severe genotypes lived in higher poverty and travelled longer for healthcare services. Persons in areas with higher annual rainfall, higher mean temperatures and living farther from factories had less painful crises and respiratory events. The paper highlights a need for better access to healthcare services for Jamaicans with SCD especially in rural areas of the island. It also reports interesting associations between environmental climatic exposures and health outcomes

Associations of neighborhood physical and crime environments with obesity-related outcomes in Jamaica

Objective To examine whether proximity and density of public open spaces, public parks, street connectivity, and serious and violent crimes were associated with Body Mass Index (BMI) and Waist Circumference (WC) within and across levels of urbanicity, sex and socioeconomic status (SES) in Jamaica, a small island developing state (SIDS). Methods Secondary analysis was conducted using data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II). All respondents were geocoded to area of residence in Enumeration Districts (EDs). Intraclass correlation coefficients (ICCs) were derived and multilevel mixed effects regression models applied to 2529 participants nested within 101 EDs from all 14 parishes in Jamaica. Results There was significant clustering across neighborhoods for mean BMI (ICC = 4.16%) and mean WC (ICC = 4.42%). In fully adjusted models statistically significant associations included: increased mean BMI among men, with increased intersection density/ km2 (β = 0.02; 95% CI = 1.96 x10-3, 0.04, p = 0.032); increased mean WC among urban residents with increased crimes/km2/yr (β = 0.09; 95% CI = 0.03, 0.16, p&lt;0.01) and among persons in the middle class, with further distance away from public parks (β = 0.30; 95% CI = 0.08, 0.53, p&lt;0.01). Conclusions Neighborhood physical and crime environments were associated with obesity-related outcomes in Jamaica. Policymakers in SIDS such as Jamaica should also note the important differences by urbanicity, sex and SES in prevention efforts designed to stem the growing obesity epidemic. </jats:sec

Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies

Introduction Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15–24 years old, in Jamaica. Methods A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005–2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models. Results Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI −2.11, −0.84] mmHg, p &lt; 0.001, for each standard deviation unit increase in PCA-SES1 score) in multivariable model accounting for age, household SES, study, BMI, fasting glucose, physical activity and diet. PCA-SES1 was not significantly associated with systolic BP among females (β −0.48 [−1.62, 0.66], p = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [z-score -1 to 0] (β4.09 [1.49, 6.69], p = 0.002), but with lower systolic BP at spline 3 [z-core 0 to 1] (β-2.81 [−5.04, −0.59], p = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males. Conclusion Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females. </jats:sec

Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study

ObjectiveTo derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.DesignCross-sectional study.SettingData from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.ParticipantsA subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.Primary outcome measureMean BMI, calculated as weight divided by height squared (kg/m2).ResultsThere was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.ConclusionsHigher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations.</jats:sec

Understanding neighbourhood retail food environmental mechanisms influencing BMI in the Caribbean: a multilevel analysis from the Jamaica Health and Lifestyle Survey: a cross-sectional study

Objective To derive estimates of the associations between measures of the retail food environments and mean body mass index (BMI) in Jamaica, a middle-income country with increasing prevalence of obesity.Design Cross-sectional study.Setting Data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II), a nationally representative population-based survey that recruited persons at their homes over a 4-month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts.Participants A subsample of 2529 participants aged 18–74 years from the JHLS II who completed interviewer-administered surveys, provided anthropometric measurements and whose addresses were geocoded.Primary outcome measure Mean BMI, calculated as weight divided by height squared (kg/m2).Results There was significant clustering across neighbourhoods for mean BMI (intraclass correlation coefficients=4.16%). Fully adjusted models revealed higher mean BMI among women, with further distance away from supermarkets (β=0.12; 95% CI 8.20×10−3, 0.24; p=0.036) and the absence of supermarkets within a 1 km buffer zone (β=1.36; 95% CI 0.20 to 2.52; p=0.022). A 10 km increase in the distance from a supermarket was associated with a 1.7 kg/m2 higher mean BMI (95% CI 0.03 to 0.32; p=0.020) in the middle class. No associations were detected with fast-food outlets or interaction by urbanicity.Conclusions Higher mean BMI in Jamaicans may be partially explained by the presence of supermarkets and markets and differ by sex and social class. National efforts to curtail obesity in middle-income countries should consider interventions focused at the neighbourhood level that target the location and density of supermarkets and markets and consider sex and social class-specific factors that may be influencing the associations