VOLUME 1
ISSUE 1
APRIL 2022
HEALTHBYTES THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
Over the past two years, the Health Taskforce has developed important relationships between health professionals in the Jamaica diaspora and organizations and individuals in Jamaica who are dedicated to the health and well-being of Jamaican residents.
PASSING THE BATON BY DR. BEVERLY GORDON The United Nations describes capacity building as “the process of developing and strengthening the skills, instincts, abilities, processes and resources that organizations and communities need to survive, adapt, and thrive in a fastchanging world.” The Jamaica Diaspora Health Taskforce (JDHTF) is one of several taskforces within the Jamaica Diaspora Taskforce Action Network (JDTAN). It is comprised of health professionals of Jamaican birth or descent, currently living in other countries, who cherish their Jamaican heritage and desire to build capacity in Jamaica. It is our desire to see Jamaica thrive.
We delivered professional development seminars, organized and produced a virtual health conference (2020) that included presentations from a broad array of Jamaican health professionals living abroad and resident Jamaican professionals and health-related organizations. We provided support and educational contributions to various health initiatives spearheaded by colleges, nursing organizations, schools, and the Mental Health Division of the Ministry of Health. Most recently, JDHTF conducted a needs assessment project that resulted in the establishment of five subcommitteesMental Health, Professional Development, Public Health, Aging and Long-term Care, and Medication Management. Each subcommittee is led by a Chair and is comprised of impressively credentialed health professionals. (Continued on page 2)
THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
IN THIS ISSUE New Taskforce Leadership
pg. 2
Oral Therapies for COVID-19 pg. 3 JDHTF Subcommittees pg. 4 Health Bytes pg. 6 Mental Illness: Stigma Culture & Family pg. 7 Health Disparity & Inequity in Access to Kidney Care pg. 9 Featured Member pg. 11 EDITORS Dr. Beverly Gordon Dr. Beverly Fray Marcia Amarsingh GRAPHIC DESIGN & LAYOUT RJ Designs PAGE 1
PASSING THE BATON
(CONTINUED FROM PAGE 1)
It has been my delight to serve for two years as Chair of the Jamaica Diaspora Health Taskforce (JDHTF). During that time, the foundation was laid for healthcare professionals in the Jamaican diaspora to contribute their intellectual and professional resources towards building capacity that will enhance the possibility for all Jamaicans to experience positive lifestyle enhancements, heightened awareness of the factors that contribute to health and well-being, and improved access to care.
I will continue to support the work of JDHTF and contribute time and resources to its success. I believe that under Dr. Fray’s leadership and vision JDHTF will continue to collaborate effectively with Jamaica’s wellestablished and respected health system. JDHTF is dedicated to identifying needs and contributing significantly to provide resources that allow organizations and communities in Jamaica to “survive, adapt, and thrive in a fast-changing world.” With Gratitude,
On March 6, 2022, Dr. Beverly Fray became the new Chair of JDHTF. I anticipate great things for the future under Dr. Fray's leadership.
Dr. Beverly Gordon
NEW TASKFORCE LEADERSHIP Dr. Fray hails from Duanvale, Trelawny and is a proud Westwood High School and UWI graduate. She migrated to the USA in 1987 and a few years later changed paths and became a registered nurse. She has specialized in behavioral health nursing as well as pain management. She is a board certified clinical nurse specialist currently employed as a corporate clinical educator at Jackson Health System, Miami. She is the proud mother of one child and grandmother of 5 year old grandson. Her other alma maters are Miami Dade College, University of Miami and Florida International University.
Marcia Amarsingh holds a Masters Degree in Counseling and is an independently Licensed Drug and Alcohol Counselor. She has worked in many capacities in the mental and behavioral health sector. Ms. Amarsingh started her private practice in 2016 treating individuals and their families who suffer from the disease of addiction. She recently partnered with likeminded colleagues to open a MASH certified male 15 bed sober house for underprivileged homeless males. Ms. Amarsingh is a strong, resilient and dignified black woman with much to offer to our black community.
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ORAL THERAPIES FOR COVID-19 BY LEIGHTON LUGG & SHAVEL CLARK
COVID-19 (coronavirus disease 2019) is a very contagious disease caused by a SARS-CoV-2 virus. COVID-19 most often causes respiratory symptoms that can feel much like a cold or a flu, but it may attack more than your lungs and respiratory system. Most people with COVID-19 have mild symptoms, but some people become severely ill. Older adults and people who have certain underlying medical conditions, such as diabetes, COPD, and other immunocompromising conditions are at increased risk of severe illness from COVID-19. Treatment for mild to moderate COVID-19 for those who are at high risk of disease progression should begin as soon as possible after diagnosis. In the United States, there are two novel oral antiviral agents, the first one being Nirmatrelvir-Ritonavir and the second is Molnupiravir. Both are available as outpatient treatment for selected patients at risk for severe disease. These agents should be initiated as soon as possible following COVID-19 diagnosis and within five days of symptom onset. THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
Nirmatrelvir-Ritonavir (Paxlovid) This is one of the preferred options for COVID-19specific therapy for symptomatic outpatients with risk factors for severe disease. It should be recommended first-line for most patients with a positive COVID-19 test who are at high risk of developing severe illness regardless of vaccination status. Persons considered high risk are those age 65 or older, diabetes, heart, and lung disease etc. Nirmatrelvir is an oral protease inhibitor that has demonstrated antiviral activity against all coronaviruses that are known to infect humans. Ritonavir is used in combination with Nirmatrelvir to increase nirmatrelvir concentrations to target therapeutic ranges. Nirmatrelvir-Ritonavir is for patients 12 years and older weighing at least 88 pounds (40kg). The dose is 300mg Nirmatrelvir (two 150mg tablets) with one 100mg ritonavir tablet taken together orally twice daily for 5 days. For patients with moderately reduced kidney function (eGFR 30 to 59 ml/min), the dose is one 150mg nirmatrelvir tablet and one 100mg ritonavir tablet taken together twice daily for 5 days. It is not recommended for patients with eGFR < 30ml/ min or for patients with (Continued on page 6) PAGE 3
JDHTF SUBCOMMITTEE LEADERS The Health Taskforce is organized into five subcommittees, each headed by a Chair who coordinates the work of the subcommittee with the Chair and Vice-chair of the Taskforce. The subcommittees work collaboratively to fulfill the mission of JDHTF and its parent body, Jamaica Diaspora Taskforce Action Network (JDTAN).
Ms. Tomlinson is a Licensed Marriage and Family Therapist who has served in several roles in social services, including overseeing the regulation of substance abuse treatment services for the Southeast Region of the State of Florida. Ms. Tomlinson currently assists organizations in program development and compliance, staff training and development, policy development and adherence as well as grant writing and asset management. She is adept at community needs assessment, resource mapping and allocation, and strategic planning. Ms. Tomlinson resides in the United States and proudly represents the parish of Manchester. Dr. Leighton Lugg is Chair of the Medication Management Subcommittee. He is from the Parish of St. Ann. He attended Marcus Garvey Technical High School. Dr. Lugg migrated to the United States and attended the University of Florida where he obtained the Doctor of Pharmacy degree. He earned an MBA degree from Nova Southeastern University. He is currently a board certified ambulatory care specialist with a focus in diabetes management at Memorial Health Care System in Florida. Dr. Bridgette Johnson is the Director of Clinical Practice and Regulatory Compliance for Jackson Health System, a nonprofit academic medical system, in Miami-Dade, Florida where she is responsible for overseeing effectiveness of clinical practice, and providing the organization-wide oversight and resolution of regulatory and hospital licensure matters including process changes, new requirements, and compliance with all regulatory standards required for patient safety and quality of care and services. Dr. Johnson has been in practice for over 25 years and has worked in several areas including nursing operations, clinical education, nursing professional development and academia. She was born in Jamaica and migrated to the United States at the age of 18. She received a Bachelor’s Degree (BSN) from Northwestern State University, a Master’s Degree (MSN) from Florida International University, and a Doctor of Philosophy (PhD) degree from Florida Atlantic University. THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
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JDHTF SUBCOMMITTEE LEADERS Dr. Sylvanus Thompson is Chair of the Public Health Subcommittee. He is the former associate director and food safety lead for Toronto Public Health. His formal education includes a BSc (Environmental Health), a MSc (Food Safety), and PhD (Public Health Administration). Additionally, Sylvanus is a Fellow of the Canadian Health Service Research Foundation which is focused on evidence-based decision making. Sylvanus has been integrally involved in numerous professional, voluntary, and community organizations including the International Federation Of Environmental Health, the National Environmental Health Association, the Jamaica Association of Public Health Inspectors, and the Jamaican Canadian Association. With his expert knowledge, professionalism, commitment, and dedication to public health Sylvanus is the recipient of a number of professional and community awards including The Governor General Jamaica Diaspora Award of Excellence and The Jamaica Diaspora and Friends Champions Award for dedicated service and contribution to the development of Jamaica.
Mrs. Novelett Stennett-James holds a Bachelor of Science degree in Health Psychology, a Master of Science degree in Human and Social Services, and is a doctoral student at Walden University in Human and Social Services. She is an advocate for older adults. For over 15 years Mrs. StennettJames has worked as a resident coordinator for persons suffering from Alzheimer’s Disease and other forms of dementia. She currently works as a clinical therapist with older adults. Mrs. Stennett-James believes that she should care for others the same way that she would want to be cared for. She is passionate about making life better for older adults.
Interested in using your skills, knowledge and expertise to make a diffrence in Jamaica's health & behavioral health sectors, join the Jamaica Diaspora Health Taskforce at www.jdtan.org
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HEALTH BYTES
According to Pan American Health Organization (PAHO), “Cancer, heart diseases, diabetes and lung disease, commonly known in the global health community as noncommunicable diseases (NCDs), together with mental health conditions, are one of the most significant challenges in global health today. Every year, there are more deaths from NCDs than any other disease group”. (International Strategic Dialogue on Noncommunicable Diseases and the Sustainable Development Goals PAHO/WHO | Pan American Health Organization)
Action is a law of life. Muscle tone and strength are lost without exertion, but exercise improves the health of body, mind, and spirit multiplying vitality and health. (https://www.newst art.com/about)
World Health Organization (WHO) defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community." (who.int)
ORAL THERAPIES FOR COVID-19 CONTINUED FROM PAGE 3
severe liver impairment. Efficacy: Evidence suggests Nirmatrelvir-Ritonavir prevents hospitalization or death in about 1 in 18 highrisk unvaccinated adults with mild to moderate COVID-19 infection. Drug interactions: Avoid with phenytoin and counsel holding some statins (lovastatin, simvastatin) until the course of treatment is completed. Molnupiravir is the second oral option. It is an alternative option to Nirmatrelvir-Ritonavir for COVID19-specific symptomatic outpatients with risk factors for severe disease who cannot use the previous oral agent. The dose is 800 mg (four 200mg capsules) taken orally every 12 hours for five days. No dose adjustment is necessary based upon kidney or hepatic impairment. Evidence suggests molnupiravir may prevent hospitalization in about 1 in 35 unvaccinated outpatients age 18 and older with mild to moderateCOVID-19 who are at high risk of developing severe illness. It should not be used in patients younger than 18 years due to bone and cartilage toxicity. It is also not recommended during pregnancy and lactation. If a patient with reproductive potential needs June 1, 2025
THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
molnupiravir, counsel to use a reliable contraception during use and for 14 days (about 2 weeks) afterward in women and at least 3 months afterward in men. In females of childbearing potential, a pregnancy test is recommended if they have irregular menstrual cycles, or who are unsure of the first day of their menstrual cycle or not consistently using effective contraception. Ritonavir-Boosted Nirmatrelvir (Paxlovid) Age: 12+ Dosage: eGFR ≥60 mL/min: 300 mg with RTV 100 mg PO twice daily for 5 days eGFR ≥30 to <60 mL/min: 150 mg with RTV 100 mg PO twice daily eGFR <30 mL/min (Not recommended) -Not recommended for Severe Hepatic Impairment Administration time from symptom onset: <5 days Molnupiravir Age: 18+ Dosage: 800 mg PO twice daily for 5 days Administration time from symptom onset: <5 days Sources Cohen, P., 2022. [online] Available at: <https://www.uptodate.com/home> [Accessed 16 February 2022]. Basics of COVID-19 | CDC Nonhospitalized Adults: Therapeutic Management | COVID-19 Treatment Guidelines (nih.gov) PAXLOVID™ (nirmatrelvir tablets; ritonavir tablets) For Patients (covid19oralrxpatient.com) PAGE 6
MENTAL ILLNESS: STIGMA, CULTURE AND FAMILY BY MARCIA AMARSINGH MSC., LADC-1, CADC, CDP
Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may be occasional or long-lasting (chronic). They can affect your ability to relate to others and function each day. (American Psychiatry Association). According to the World Health Organization, mental disorders account for nearly twelve percent of the global disease burden with depression the most common and will become the leading cause of disability by 2020. It is estimated that at least 10% of the world's population is affected, and that 20 % of children and adolescents suffer from some type of mental disorder. According to the Jamaican Health Minister, Dr. Christopher Tufton citing a local survey, four of every ten Jamaicans at some point in their lives will suffer from some form of mental illness. In addition, one in every five young people suffer from mental illness. The highest overall prevalence of depression is in the 15 to 24, 25 to 34 and over 75 years age groups. Dr. Tufton noted that between 45 and 55 persons commit suicide each year in Jamaica based on mental illness. THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
REASONS ONLY FEW SEEK TREATMENT There is no doubt that mental illness is a major problem, yet so few seek treatment. According to the Mental Health Foundation, in 2014 only one in eight adult suffering from mental illness seek treatment (12.1%), with 10.4% taking medications and only 3% getting psychotherapy. Barriers to seeking treatment include stigma, culture, and lack of community/ family support. DEFINITION OF STIGMA Stigma is defined as a mark of shame or discredit; an identifying mark or characteristic specifically: a specific diagnostic sign of a disease. (MerriamWebster Dictionary). Stigma is the devaluing, disgracing and disfavoring by the general public of individuals with mental illness. Stigma often leads to discrimination or inequitable treatment of individuals and the denial of the rights and responsibilities that accompany full citizenship. The World Health Organization has identified stigma and discrimination towards mentally ill individuals as the single most important barrier to overcome in the community (WHO, 2001). HARMFUL EFFECTS OF STIGMA Feelings of shame Hopelessness Isolation Reluctance to ask for help or get treatment (continued on page 8) PAGE 7
MENTAL ILLNESS: STIGMA, CULTURE AND FAMILY CONTINUED FROM PAGE 7
Lack of understanding by family, friends or others. Fewer opportunities for employment or social interaction Bullying, physical violence or harassment Self-doubt: the belief that you will never overcome your illness or be able to achieve what you want in life. CULTURE Culture is the characteristics and knowledge of a particular group of people, encompassing language, religion, cuisine, social habits, music and the arts. Thus, it can be seen as the growth of a group identity fostered by social patterns unique to the group. Mental health is considered by some cultures to be a weakness, something to hide, shame and embarrassment. Often this prevents those struggling to talk openly about it. Culture influences how people feel and describe their symptoms. COMMUNITY SUPPORT Fear of discrimination and rejection often prevents people from reaching out. It is often difficult to find resources and treatment options that take into account specific cultures, factors and needs. Many people do not see mental illness as medical; instead they view it as lack of emotional harmony or caused by evil spirits or a spell. MENTAL HEALTH STIGMA IN JAMAICA In October 2019, the Ministry of Health and Wellness launched a campaign called “Speak Up, Speak Now” which provided a platform for mentally ill individuals to share their stories. This was intended to raise awareness about mental illness, to stimulate a national conversation on mental health and to end the stigma against mental illness in Jamaica. According to the health minister, Jamaicans view mental illness as hopeless, outcasts who should be locked up and refer to them as mad people. In a study entitled Mental Illness Stigma in Jamaica (Arthur et al, 2010) it was concluded that mentally ill persons are viewed as dangerous, vulnerable, lacking control; and were treated with avoidance, abuse, exploitation, and discrimination. They were ostracized and seen as bad. They also reported significant sexual abuse and exploitation of women THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
with mental illness. Arthur et al, further discussed two types of mental disorders described by Jamaicans: “madness” and “mental illness.” Madness- individuals exhibiting violent behavior and or homelessness often combined with a poor or dirty outward physical appearance. It’s viewed as permanent and pervasive impacting all areas of the person’s functioning. Mental Illness- applied to conditions perceived as milder and able to function in some situations. Treatment of madness is significantly different than mental illness. The history of mad is complicated both in form and in meaning. In form, mad goes back to Old English meaning “troubled in mind, demented.” According to the Merriam-Webster Dictionary madness is defined as the quality or state of being mad: such as a state of severe mental illness, behavior or thinking that is very foolish or dangerous, extreme intense anger. “Mad” or “Madness” in the Jamaican context could be a state of dishevelment, homelessness and violent behavior often referred to as “mad, sick, head no good.” A psychiatric hospital is often referred to as “Madhouse.” CHANGING THE EXISTING STIGMA Education: learning the facts about mental illness and sharing them with family, friends, work colleagues and classmates. Community mental health services. Workplace Employee Assistance Program (EAP) Advocacy groups for mental illness Avoid using language that puts the illness first and the person second (e.g., saying “a person with bipolar disorder” instead of “that person is bipolar"). Correcting someone when they make stereotypical or inaccurate comments about mental illness. Sharing your own experience of mental illness through personal stories and media outreach. Treating all people with respect and dignity, not judging, label or discriminating when you meet persons with mental illness. Hospitalization and other forms of treatment instead of arrests and incarcerations for the mentally ill. Mental health and suicide prevention helpline.
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HEALTH DISPARITIES AND INEQUITY IN ACCESS TO KIDNEY CARE A REVIEW OF LITERATURE ON KIDNEY CARE IN JAMAICA AND OTHER LOW- AND MIDDLE-INCOME COUNTRIES BY DRS. NADIA MCLEAN AND O’NEAL MALCOLM This article was first published in the American Society of Nephrology (ASN) Kidney News Journal Magazine (March 2022 Edition)
Chronic kidney disease (CKD) is a significant cause of morbidity and mortality worldwide. The global burden of CKD is estimated at 500 million people worldwide, with the majority of people with CKD (80%) living in low- and middle-income countries (LMICs) (1). In 2017, 1.2 million people died from CKD, with the all-age mortality rate increasing 41.5% between 1990 and 2017 and a global prevalence of 9.1%. The global all-age prevalence of CKD also represented an increase of 29.3% since 1990 (2). Along with the noted increases, there is inequity in the distribution of CKD; people living in LMICs are disproportionately affected more than people living in high-income countries (HICs) (1). Stanifer et al. (1) noted that although CKD in 2016 represented the 19th-most common cause of death worldwide—an 82% increase since 1990—the annual death rate attributed to CKD is growing more than 5% per year.
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The National Kidney Foundation Kidney Disease Outcomes Quality Initiative introduced a framework for the definition of CKD. The aim of the model is to depict risk factors that could be associated with progression to more severe stages of CKD (3). CKD was initially defined based on the presence of kidney damage or a reduction in glomerular filtration rate for more than 3 months (3). In 2004, Kidney Disease: Improving Global Outcomes (KDIGO) endorsed this framework, noting that proteinuria worsened the progression of CKD (4). By standardizing the definition of CKD and offering treatment guidelines, these models have presented an important basis for the diagnosis and management of kidney diseases in LMICs, such as Jamaica, and help us to elucidate the scope of the challenge in delivering expert kidney care to adults and children in this setting by providing a standardized basis for data collection, analysis, and policy recommendations. The characterization of the scope of kidney diseases in Jamaica is foundational to an understanding of the burden faced by patients and providers, including lack of care and resources, workforce shortages, and chronic disease burden (5). With results from a survey of a specialist diabetes clinic in Jamaica, Ferguson et al. (6) estimated the prevalence of CKD to be 22%. Of note, moderate and severe (Continued on page 10)
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Health Disparities and Inequity in Access to Kidney Care CONTINUED FROM PAGE 10
albuminuria, known to advance CKD, was present in 82.6% of the population (6). The Caribbean Renal Registry, established in 2006, highlighted the difference in patterns of CKD and end stage kidney disease (ESKD) in LMICs. These patterns included high rates of health care demand compounded by a lack of trained nephrologists throughout the Caribbean region. As with other LMICs, such as those in Asia and parts of Africa, there was also inequitable access to kidney replacement therapies (KRTs), including peritoneal dialysis, hemodialysis, and kidney transplantation (5). Inequity among adults also translates to the pediatric population of LMICs. In 2016, Miller and Williams (7) noted that between 2007 and 2012, 27 children developed CKD, with a cumulative annual incidence per million child population of 7.83 for children under age 12 years and 1.67 for the average population. The study also noted a paucity of pediatric data in LMICs and lack of access to KRTs. A meta-analysis by Plumb et al. (8) noted an increased risk of late presentation among the pediatric population from LMICs. These children tended to be older and already hospitalized under emergent situations, which increased their risk of poor health outcomes, including mortality. The study pointed to the need for policy focus on reducing modifiable barriers to improve access to care, such as consensus definitions, protocols focused on risk stratification, and early specialist intervention (8). It has been established that the burden of kidney failure in LMICs approaches that of HICs, but relatively few patients in LMICs receive KRTs (9). Currently, children throughout Jamaica primarily receive KRTs in the capital, Kingston. Major challenges for the pediatric population residing outside of Kingston, including rural areas, are distance, travel duration, and transportation availability. The inequity in access to care extends to the most rural and often resource-limited parts of the country where transportation is unreliable and costly. White et al. (9) proposed a framework for reducing the global burden of ESKD and improving access to KRTs. This model included a national registry of dialysis and transplant patients, national policy and THE OFFICIAL JAMAICA DIASPORA HEALTH TASKFORCE NEWSLETTER
budgetary planning about KRT delivery and eligibility, retention and training of skilled personneland education at the community and regional levels. This framework and call to action were echoed by Ameh and colleagues in 2019 (10). Their review highlights factors hindering the prevention of CKD progression in LMICs. These components include poor funding of health care, struggling health care systems, lack of local data, and costs of screening systems—all of which prevail among the population in Jamaica (10) (Table 1). We hope to highlight the inequity as it relates to access to diagnosis, expert care management, and KRTs faced by adults and children living in rural parts of Jamaica, a LMIC. It is our hope that data from this article will represent the basis of recommendations to increase access to care for this vulnerable population and to improve health care outcomes and reduce morbidity and mortality. References 1. Stanifer JW, et al. Chronic kidney disease in low- and middle-income countries. Nephrol Dial Transplant 2016; 31:868−874. doi: 10.1093/ndt/gfv466 2. GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395:709−733. doi: 10.1016/S0140-6736(20)30045-3 3. Levey AS, et al. The definition, classification, and prognosis of chronic kidney disease: A KDIGO Controversies Conference report. Kidney Int 2011; 80:17−28. doi: 10.1038/ki.2010.483 4. Levey AS, et al. Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67:2089−2100. doi: 10.1111/j.15231755.2005.00365.x 5. Soyibo A, et al. Chronic kidney disease in the Caribbean. West Indian Med J 2011; 60:464−470. https://www.mona.uwi.edu/fms/wimj/system/files/article_pdfs/dr_soyib o.qxd__0.pdf 6. Ferguson T, et al. Prevalence of chronic kidney disease among patients attending a specialist diabetes clinic in Jamaica. West Indian Med J 2015; 64:201−208. doi: 10.7727/wimj.2014.084 7. Miller M, Williams J. Chronic renal failure in Jamaican children: 2007−2012. Chronic Dis Int 2016; 3:1024. https://austinpublishinggroup.com/chronicdiseases/fulltext/chronicdiseases-v3-id1024.php 8. Plumb L, et al. The incidence of and risk factors for late presentation of childhood chronic kidney disease: A systematic review and metaanalysis. PLoS One 2020; 15:e0244709. doi: 10.1371/journal.pone.0244709 9. White S, et al. How can we achieve global equity in provision of renal replacement therapy? Bull World Health Organ 2008; 86:229–237. doi: 10.2471/blt.07.041715 10. Ameh OI, et al. Preventing CKD in low- and middle-income countries: A call for urgent action. Kidney Int Rep 2019; 5:255−262. doi: 10.1016/j.ekir.2019.12.013
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FEATURED MEMBER
Dr. Roy Anthony Thompson Dr. Roy Anthony Thompson was born and raised in St. Catherine, Jamaica. He grew up in two small communities: Lime Tree Grove near Spanish Town and Salt Pond Gardens near Portmore. His mother worked in the sugar cane field at Bernard Lodge Estate to provide for his three siblings. He graduated from St. Catherine High School in 2002 and went on to eventually pursue a career in nursing. He obtained a Bachelor of Science in Nursing in 2007 with first class honors from The UWI School of Nursing, Mona. While at UWI he was a lead tenor in the University Singers from 2002-2016; and won the Actor Boy Award in 2016 for best supporting actor in his role as the “Narrator” in the University Singer’s nationally acclaimed opera “1865” which is about the story of the Morant Bay Rebellion of 1865. He practiced as a registered nurse at The University Hospital of the West Indies mainly in the Intensive Care Units (ICUs) and Recovery Room. In 2009 he obtained a post-basic certificate in critical care nursing. While lecturing at UWI he taught and coordinated undergraduate courses in patient and healthcare worker safety, nursing care of the older adults and specialized nursing care.
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From 2016-2022 Mr. Thompson attended Duke University, a top-ranked ranked nursing school in the United States where he pursued and recently successfully completed his Doctor of Philosophy (PhD) in Nursing and the Global Health Doctoral Certificate from the Duke Global Health Institute. His research focuses on international nursing migration, care of older adults, long term care and health policies. While at Duke University he received a Teaching for Equity Fellowship and pilot funding grant from the Duke School of Nursing. He also received a field grant from the Duke Global Health Institute to support his dissertation research. No stranger to breaking glass ceilings, Mr. Thompson recently became the first Black male to defend the PhD in Nursing at Duke University. Mr. Thompson was recently unanimously selected and will begin a post-doctoral fellowship at the University of Missouri this August 2022. Mr. Thompson publishes his work on care of older adults and addressing systemic racism in academic journals. He received national recognition in the United States and was commissioned by the journal, Research in Nursing and Health (RINAH) which has an international readership, to produce a year-long series of publication on learning the language of health equity. Mr. Thompson is also currently a subject matter expert on the US’ National Commission to Address Racism in Nursing.
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