Dominican Republic Research Articles

Assessment of Soil Heavy Metal Pollution and the Ecological Risk in an Agricultural Area from Sánchez Ramírez Province, Dominican Republic

Assessment of Soil Heavy Metal Pollution and the Ecological Risk in an Agricultural Area from Sánchez Ramírez Province, Dominican Republic

Longitudinal changes in hand hygiene adherence among healthcare workers during the COVID-19 pandemic, Dominican Republic

Hand hygiene (HH) can reduce transmission of healthcare-associated infections (HAIs) in healthcare facilities and is especially important in low- and middle-income countries where HH infrastructure may be insufficient and the burden of HAIs is highest. At baseline, we assessed HH infrastructure and practices among healthcare workers (HCWs) at two large hospitals in the Dominican Republic during the COVID-19 pandemic. HCWs were observed for HH adherence (HHA) (defined as the use of alcohol-based hand rub (ABHR) or handwashing with soap and water) before and after patient contact and donning new gloves before patient contact. The baseline assessment was repeated following implementation of local production and distribution of ABHR and a HH promotion campaign. Descriptive analyses and regression models evaluated predictors of HHA and glove use. Cumulative HHA was 18.9%. While patient-care areas with a functional HH resource increased from 47% at baseline to 92% after the intervention, HHA declined from 23.0% to 16.7%. HHA was higher after patient contact (aOR = 5.88; 95% CI = 4.17–8.33), during a period of increased COVID-19 risk (aOR = 1.69; 95% CI = 1.05–2.77), during invasive patient contacts (aOR = 1.64; 95% CI = 1.23–2.17) and when gloves were not used (aOR = 1.25; 95% CI = 1.01–1.56). The negative association between glove use and HHA diminished when access to HH resources increased. New gloves were donned before 39.6% of patient contacts. Glove use was higher among nurses (aOR = 7.12; 95% CI = 3.02–16.79) and during invasive contacts (aOR = 4.76; 95% CI = 2.27–10.0). While access to HH resources increased after the interventions, HHA did not increase. HHA was lower when COVID-19 risk was lower. Findings from this study may guide future efforts to increase HHA among HCWs.

Exploring Digital Competencies: Validation and Reliability of an Instrument for the Educational Community and for all Educational Stages

AbstractDigital competencies are very significant in terms of integrating digital resources into educational processes. This study presents the validity and reliability of an instrument created by Carrera et al. (2011), in order to evaluate the basic digital competence of the three main educational agents of the educational community (teachers, students, and parents) for all educational stages (Early Childhood Education, Primary Education, Secondary Education and Higher Education), making use of digital resources to (1) Skills in management and transfer of technological data, (2) Software and hardware skills, (3) Web navigation skills, (4) Skills in using word processors, (5) Data processing and management skills, y (6) Multimedia presentation design skills. The application of the instrument was carried out with a sample of 1,149 participants from all educational stages, coming from the entire territory of the Dominican Republic. Reliability was assessed using various measures, including Cronbach’s Alpha, Spearman-Brown Coefficient, Guttman’s Two Halves, McDonald’s Omega, and composite reliability. To validate the instrument, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out with the purpose of understanding the validity and dimensionality of the scale (comprehension validity, construct validity, convergent, discriminant and invariance validity). The results demonstrated highly satisfactory reliability, and in terms of construct validity, a good fit of the model was observed, valid for any educational agent and for any educational stage. The final version of the instrument consists of 20 items classified into six latent factors.

Inclusive education in the Dominican Republic: teachers’ perceptions of and practices towards students with diverse learning needs

IntroductionStudents with diverse learning needs, particularly those with disabilities or identified as overaged, face significant challenges within the Dominican Republic’s education system. Despite efforts by the Ministry of Education to promote inclusion, these learners often have limited access to quality pedagogical support. This is further confounded by the fact that there is a paucity of research examining how teachers perceive and interact with these learners.MethodsThis ethnographic study draws on diverse methods, including observations and interviews, to investigate teachers’ perceptions of inclusion in two public schools and how these perceptions shaped their pedagogical practices.ResultsThe authors illuminate how teachers’ perceptions of their students, their schools, and their classroom environments influence their commitment to facilitating student learning, irrespective of student age or ability.DiscussionThe findings contribute valuable insights to inform strategies for enhancing inclusive education in the Dominican Republic. Recommendations for policy and teacher training are provided, and the importance of conducting research with teachers is explained.

Differences of skin carotenoids and adherence to the Mediterranean Diet pattern in adults from Southern Italy and Dominican Republic

BackgroundThe measurement of the skin carotenoids using the Veggie Meter® has emerged as a rapid objective method for assessing fruit and vegetable intake, highly recommended by the Mediterranean Diet (MD), which represents one of the healthiest dietary patterns, worldwide. This study aimed to examine differences in skin carotenoid content and degree of adherence to the MD pattern between two adult populations from Southern Italy and the Dominican Republic.MethodsThis cross-sectional study enrolled a total of 995 adults, 601 subjects from Italy and 394 from the Dominican Republic. All participants underwent anthropometric measurements and skin carotenoid assessment by Veggie Meter®. Adherence to the MD and lifestyle were evaluated using the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Lifestyle Index (MEDLIFE) questionnaires. Correlations between the skin carotenoid and MEDAS score were estimated using Pearson’s correlation coefficient. Multiple linear regression models were created to determine variables that affect skin carotenoid score for both populations.ResultsMean total skin carotenoids were higher in the Italian compared to the Dominican Republic population (342.4 ± 92.4 vs 282.9 ± 90.3; p < 0.005) regardless of sex (women: 318.5 ± 88.9 vs 277.3 ± 91.9, p < 0.005 and men: 371.7 ± 88.3 vs 289.5 ± 88.1, p < 0.005), and remaining statistically significant after age-adjustment of the Dominican Republic sample. Using the MEDAS questionnaire, we found a higher MD adherence score in the Italian than in the Dominican Republic population also after age-adjusting data (7.8 ± 2.1 vs 6.2 ± 3.7; p < 0.005) and even when categorized by sex (Italian vs age-adjusted Dominican Republic women: 7.9 ± 2.1 vs 6.3 ± 2.6; Italian vs age-adjusted Dominican Republic men: 7.7 ± 2.2 vs 6.0 ± 4.7; p < 0.005). Using the MEDLIFE test, total Italians presented a lower score with respect to the age-adjusted Dominican Republic population (3.2 ± 1.2 vs 3.4 ± 1.4; p < 0.05). In multiple regression analysis, skin carotenoids were associated with sex and negatively associated with BMI in the Italian population (sex: β: 54.95; 95% CI: 40.11, 69.78; p < 0.0001; BMI: β: − 1.60; 95% CI: − 2.98,0.86; p = 0.03), while they resulted associated with age and sex in the Dominican Republic population (age: β: 2.76; 95% CI: 1.92, 3.56; p < 0.001; sex: β: 23.29; 95% CI: 5.93, 40.64; p = 0.009). Interestingly, skin carotenoids were positively correlated with MEDAS score in both populations (Italy: r = 0.03, p < 0.0001, Dominican Republic: r = 0.16, p = 0.002).ConclusionsThis study provides the assessment of the adherence to the MD and skin carotenoid content in adults living in Southern Italy and the Dominican Republic, showing a higher MD adherence score and a skin carotenoid content in inhabitants from the Mediterranean region. Our findings highlight the need to globally encourage fruit and vegetable intake, particularly in non-Mediterranean area.

Genetic Landscape of Hearing Loss in the Caribbean: A Narrative Review.

The Caribbean region has a diverse population of about 40 million people, spread over 13 sovereign states. This review aims to describe the existing studies on hereditary hearing loss (HL) in the Caribbean population. We systematically reviewed scientific articles on HL prevalence, genetic causes, technology use, and environmental effects in Caribbean nations and the Caribbean diaspora in the United States. Key findings show that HL rates, with diverse genetic variables, vary across Puerto Rico, Cuba, and the Dominican Republic. Local resources and technology have been used to diagnose HL, particularly in rural areas. Environmental factors tend to affect HL prevalence in various regions. This literature review of Caribbean-focused studies helps guide future research and healthcare strategies, particularly concerning genetic drift caused by migration to the United States. Understanding these factors can help diagnose and treat HL in America's diverse population.

SLARD consensus for the treatment of focal chondral lesions of the knee

ObjectivesTo establish a consensus of the Latin American knee surgeons from SLARD for treating focal chondral lesions of the knee. MethodsA formal consensus was conducted among three groups of surgeons from the Latin American society of arthroscopy (SLARD) with special interest in cartilage. First, the steering group (n=9), created a list of 21 statements on controversial topics and compiled a review of literature for each topic. Secondly, the rating group (n=19), gave a score to each statement according to their agreement with it, over two rounds (score: 1-9). Median scores and agreement levels were calculated and each statement was categorized as inappropriate, uncertain or appropriate. Finally, the lecture group (n=24), evaluated the appropriateness and clinical relevance for each statement. ResultsDuring the first round, there was strong agreement on 5% of the statements, relative agreement on 14% and lack of consensus on 81% of statements. After the second round, there was strong agreement on 57% of statements, with 43% having relative agreement and no statement having a lack of consensus. The lecture group approved all the statements. ConclusionSLARD arrived at a consensus on the 21 statements proposed. This consensus includes literature review and clinical experience, which represents the expert opinion of a society. Strong agreement was found in the advantage of using arthroscopy to diagnose chondral lesions, pre-injury level as an age modification of treatment, superiority of nanofractures compared to microfractures, advantages of adding scaffolds, benefits of PRP in the midterm and faster return to sport with osteochondral autografts. Level of evidenceIV. What are the new findingsThis is the first formal consensus from SLARD about the treatment of focal chondral lesions of the knee.This consensus includes 55 orthopaedic surgeons from 13 countries in Latin America (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Guatemala, México, Panama, Peru and Uruguay).This consensus about focal chondral lesions presents 21 statements in relation to the actual evidence, but also according to the Latin American context, available resources and experience.

Hand hygiene perceptions, preferences, and practices among hospital staff in the Dominican Republic in the context of COVID-19: a qualitative study

Hand hygiene perceptions, preferences, and practices among hospital staff in the Dominican Republic in the context of COVID-19: a qualitative study

Silvopastoral arrangements and tree species diversity on dairy farms of Monción, Dominican Republic

Traditional livestock systems of the Northwest of the Dominican Republic require a transformation towards sustainable productive alternatives such as silvopastoral systems (SPS), which result from the combination and interaction of trees-animals-grass. Therefore, the study was carried out with the objective of studying the diversity of silvopastoral arrangements and their tree species in dairy production systems of the municipality of Monción, Santiago Rodríguez, Dominican Republic, for the promotion of these systems as a sustainable alternative to the climate change. The silvopastoral arrangements and their tree species were studied through direct inspection and application of semi-structured interviews to selected livestock producers from Monción. Dasometric variables were measured (e.g.: chest diameter or CD, total height) and descriptive statistics were applied. It was evident that the most predominant SPS was scattered trees (87 %), followed by windbreaks (23 %) and trees on boundaries (20 %). The least frequent arrangements were living fences (13 %), riparian forests (7 %) and forest patches (7 %). 26 tree species were recorded, the four being dominant: Prosopis juliflora(21 %), Pinus occidentalis(17 %), Mangifera indica(10 %) and Swietenia mahagoni(9 %). The species Acacia skleroxylaobtained the highest height with 8.62 m and M. indicastood out with the highest DBH with 54.85 cm. It is recommended that Monción ranchers expand the tree coverage of their farms with the replanting and management of species such as Gliricidia. sepium, P. julifloraand Guazuma ulmifolia, in order to enrich the forage alternatives for their livestock.

Biomonitoring of the confluence of the Maguaca and Yuna rivers, Cotui, Dominican Republic

The degradative processes such as mining cause loss of species, forest cover, ecosystem services and contaminate bodies of water. Under this problem, the behavior of the water quality of the confluence of the Maguaca and Yuna rivers, in the municipality ofCotuí, Dominican Republic, associated with mining activities, was determined. The research was carried out during two moments: December 2020 (t1) and February 2021 (t2). For this, a deterministic sampling of seven equidistant points in the Maguaca River, and two in the Yuna River, was carried out at t1 in rainy season and t2 in dry season. In addition, the presence of benthic macroinvertebrate species was analyzed as indicators of water quality according to the BMWP-Cub method, and the composition and structure of the riparian vegetation was determined. Likewise, the spatial behavior of the physicochemical variables of water such as potential hydrogen (pH), salinity, electrical conductivity (EC), turbidity, biological oxygen demand (BOD), nitrates (NO3-), chemical oxygen demand (COD), phosphates (PO43-), temperature, dissolved oxygen (O2D), total organic carbon (TOC), and iron concentration (Fe). Water of critical quality (very contaminated) was obtained in the upper part and very critical quality (heavily contaminated) in the lower part, at both times. It is recommended to strengthen monitoring policies for environmental, socioeconomic and health effects.

The conveyance of animal commodities in pre-contact northern Hispaniola: zooarchaeological research and isotopic niche space modelling at El Carril, Dominican Republic (ca. AD 1100–1500)

The conveyance of animal commodities in pre-contact northern Hispaniola: zooarchaeological research and isotopic niche space modelling at El Carril, Dominican Republic (ca. AD 1100–1500)

Oral Health-Related Quality of Life in a Paediatric Population in the Dominican Republic.

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children's parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city.

Milestone Moments: Community Violence and Women's Life‐Course Transitions in Colombia, the Dominican Republic, and Guatemala

AbstractDeadly violence has drastically increased in Latin America, posing a serious threat to women's sexual and reproductive health. Previous research has documented both increases and declines in youth‐to‐adulthood transitions associated with exposure to violence globally. However, there has been a lack of comparative studies focusing on multiple life‐course transitions. This study investigated the impact of community violence on women's life‐course transitions in Colombia, the Dominican Republic, and Guatemala. Drawing on nationally representative surveys and homicide statistics, fixed effects models are employed to estimate the correlation between women's exposure to community violence and the intensity, timing, and sequencing of their critical life events: first cohabitation and childbirth. The results revealed that exposure to violence was associated with an increase in the quantum and tempo of transitions to first cohabitation and birth in Colombia. Competing risk models showed that community violence correlated with the sequencing of cohabitation and birth in the Dominican Republic, as identified by an increase in precohabiting fertility. There was suggestive but inconclusive evidence of an association between community violence and transitions to first birth in Guatemala. In conclusion, community violence indeed predicts women's youth‐to‐adulthood transitions in Colombia, the Dominican Republic, and potentially Guatemala, with repercussions for the subsequent life experiences of individuals and entire cohorts.

Rate of severe exacerbations, healthcare resource utilisation and clinical outcomes in patients with COPD in low-income and middle-income countries: results from the EXACOS International Study.

The EXAcerbations of Chronic obstructive lung disease (COPD) and their OutcomeS (EXACOS) International Study aimed to quantify the rate of severe exacerbations and examine healthcare resource utilisation (HCRU) and clinical outcomes in patients with COPD from low-income and middle-income countries. EXACOS International was an observational, cross-sectional study with retrospective data collection from medical records for a period of up to 5 years. Data were collected from 12 countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Guatemala, Hong Kong, Mexico, Panama, Russia and Taiwan. The study population comprised patients ≥40 years of age with COPD. Outcomes/variables included the prevalence of severe exacerbations, the annual rate of severe exacerbations and time between severe exacerbations; change in lung function over time (measured by the forced expiratory volume in 1 s (FEV1)); peripheral blood eosinophil counts (BECs) and the prevalence of comorbidities; treatment patterns; and HCRU. In total, 1702 patients were included in the study. The study population had a mean age of 69.7 years, with 69.4% males, and a mean body mass index of 26.4 kg/m2. The mean annual prevalence of severe exacerbations was 20.1%, and 48.4% of patients experienced ≥1 severe exacerbation during the 5-year study period. As the number of severe exacerbations increased, the interval between successive exacerbations decreased. A statistically significant decrease in mean (SD) FEV1 from baseline to post-baseline was observed in patients with ≥1 severe exacerbation (1.23 (0.51) to 1.13 (0.52) L; p=0.0000). Mean BEC was 0.198 x109 cells/L, with 64.7% of patients having a BEC ≥0.1 x109 cells/L and 21.3% having a BEC ≥0.3 x109 cells/L. The most common comorbidity was hypertension (58.3%). An increasing number of severe exacerbations per year was associated with greater HCRU. The findings presented here indicate that effective treatment strategies to prevent severe exacerbations in patients with COPD remain a significant unmet need in low-income and middle-income countries.

Adherence, Burden, and Morbidity in Adults with Chronic Diseases in the Dominican Republic: A Cross-sectional Study in a Tertiary-level Hospital (A-CaMo II)

Introduction: Pharmacological adherence is a key factor in managing chronic non-communicable diseases (NCDs), so its efficacy concerning new therapies emerges as an essential consideration. Despite efforts, adherence rates vary widely, highlighting the complexity of the problem. Non-adherence affects treatment effectiveness and increases patient burden and medical costs. Understanding the interplay between burden, morbidity, and adherence is crucial for adapting health strategies. Objective: This study aims to measure pharmacological adherence, burden, and morbidity among patients with chronic diseases in the Dominican Republic, emphasizing the interplay between these dimensions. Methods: Data were collected using a cross-sectional design at the Centro Médico de Diabetes, Obesidad y Especialidades (CEMDOE) in Santo Domingo during August 2023. Patient interviews were conducted using standardized tools, including the Medication Adherence Reasons Scale (MAR-Scale) and the Disease Burden Morbidity Assessment (DBMA). Nonprobability convenience sampling yielded a sample of 384 patients who met the inclusion criteria. Significant statistical analysis included an ordinal regression analysis correlating medication adherence with disease burden. Results: Among the patients studied, the ordinal regression analysis unveiled a significant correlation (p = 0.001) between nonadherence and disease burden, indicating a 0.29 ± 0.09 unit increase in burden for every one-point decrease in adherence score. Patients with private health insurance and higher education levels exhibited more excellent adherence rates (65.97% and 63.89%, respectively), with a substantial portion also reporting a burden score ≥ 5 (70.07% and 70.42%, respectively). Moreover, the study population experienced a significant burden of multimorbidity (88.8%), with hypertension displaying the lowest burden (1.63 ± 1.13) despite its prevalence (76.76%). Conclusion: Despite the limitations, common reasons for non-adherence were identified, and significant disease burdens were observed, particularly in osteoarthritis, cancer, and rheumatoid arthritis. Notably, a positive association was found between adherence and disease burden, underlining the importance of adherence in chronic disease management. Health disparities affecting access to medication and patient education were observed, highlighting the need for further research and intervention. The combined use of a scale that integrates both the DBMA and the MAR-Scale, in which adherence, burden, and morbidity are investigated simultaneously for each disease, would allow for a more comprehensive approach to all three characteristics regardless of which disease is included in the scales separately.

Aesthetic Surgery Complications Disproportionately Burden Economically Disadvantaged Patients and Financially Strain Public Health Insurance: A Single Academic Center Retrospective Analysis

Abstract Goals/Purpose Complications of elective aesthetic surgery performed in private practice pose significant morbidity to patients and resource burden to healthcare systems. We aimed to characterize contemporary demographic and complication patterns among patients presenting to an academic center after aesthetic surgery, as well as the financial and resource burden of their postoperative care on the hospital and payor. Methods/Technique We performed a retrospective review of patients who presented to an urban, academic hospital emergency department in Northern California from September 1, 2020 to September 30, 2023. We included patients with primary complaints related to aesthetic procedures performed at outside centers resulting in a plastic surgery consultation. Demographics, outcomes, hospital charges, and insurance payments were determined. Univariable analyses identified associations with outcomes. Results/Complications We identified 36 patients with aesthetic procedure-related complaints. Mean age was 37.5 ± 9.8 years and all patients were female. Compared with the rest of the patient population presenting to the emergency department over the same time period (n=269,286), the identified patients were more likely to be black (34.3% vs. 20.4%, p=.04), Hispanic (40% vs. 24.6%, p=.03), and on Medicaid (80.6% vs. 31.7%, p&amp;lt;.001). Tobacco/cannabis use and obesity were prevalent in 25% and 47.2% of patients, respectively. Most patients underwent aesthetic procedures in the United States (51.4%), followed by Mexico (37.1%) and the Dominican Republic (11.4%). Body regions intervened upon were the abdomen (52.8%), breasts (52.8%), buttocks (33.3%), and arms (8.3%). In 36.1% of patients, multiple body regions were intervened upon during the index case. Abdominal cases included primary abdominoplasty (84.2%), panniculectomy (10.5%), and revision abdominoplasty (5.3%). Breast cases were primary augmentation (36.8%), revision augmentation (21.1%), augmentation mastopexy (15.8%), mastopexy only (15.8%), and other (10.5%). Buttocks cases were gluteal fat grafting (63.6%) and implant insertion (36.4%). Arm cases were all brachioplasty. Median postoperative day was 21 (Interquartile Range [IQR] 11.5, 36). Reasons for presentation included infection (44.5%), dehiscence (16.7%), pain (16.7%), seroma/drainage (11.1%), drain management (5.6%), and hematoma (2.8%). Nearly half received computed tomographic imaging (47.2%). Half of patients were admitted with a median length of stay of 2.5 days (IQR 1, 3). One-third underwent intervention, including implant removal (58.3%), image-guided aspiration (25%), and incision and drainage (16.7%). Patients using tobacco/cannabis were more likely to present with infection (88.9% vs. 25.9%, p=.001) and undergo intervention (66.7% vs. 22.2%, p=.01). There were recurrent emergency department visits among 22.2%. Overall, 44.4% of patients had outpatient follow-up visits for a median of 3 (IQR 2, 4) visits up to a median of 38 (IQR 21.5, 70.5) days after consultation. For the index hospital encounter and any subsequent outpatient/emergency visits, the total median hospital charge was $43,324.96 (IQR $10,728.12, $80,803.18) and median insurance payment was $3,947 (IQR $404.61, $24,516.00). In the setting of operative intervention, median hospital charge and insurance payments were $125,358.70 (IQR $51,065.52, $152,704.70) and $14,863.52 (IQR $3,947, $49,031.13), respectively. Conclusion In this case series, the majority of patients presenting with complaints related to aesthetic surgery were economically disadvantaged and nearly half received surgery abroad. Their surgical complications often directly and significantly cost the state-funded health insurance and strained inpatient and outpatient resources. Nearly a quarter of patients were offered aesthetic surgery despite active smoking, and they were more likely to develop infection and receive invasive treatments. While future analysis should aim to replicate our findings in a larger sample, providers and government agencies should warn their vulnerable patients of these risks.

Efficient reuse of Sargassum spp. biomass and organic fraction of municipal solid waste by anaerobic co-digestion in the Dominican Republic: Evaluation of biochemical methanogenic potential and reaction rates

Anaerobic digestion (AD) is a potential solution to valorize invasive pelagic Sargassum spp. Sargassum spp. (SP) biomass is characterized by a low carbon/nitrogen (C/N) ratio, which, in addition to the presence of indigestible fiber, sulfide, salt, ash, and polyphenol content, are inhibitors to the AD process. Furthermore, its chemical composition depends on the season and region of harvesting. To increase biogas yields, biomass must be subjected to pre-treatment or an anaerobic co-digestion process with other waste biomass. In this paper results of co-digestion of Sargassum spp. and municipal solid waste (OFMSW) batches with different weight ratios are reported and compared with the mono-digestion of the two organic matrices. The objective is to provide an optimized SP to OFMSW ratio for the sustainable production of biogas in the Dominican Republic. Mono-digestion of Sargassum spp. showed the longest reaction time and the lowest biomethane yield as it lasted 30 days and provided a cumulative volume of biomethane equal to 79.68 NmLg−1VS. The addition of OFMSW led to the shortening of the reaction time to 10 days and to the increase of the yield and cumulative volume of biomethane. It can be attributed to the more favorable C/N ratio, to the presence of more readily digestible compounds and lower ash content of those batches. The reaction kinetics of all the investigated batches is properly fitted by the Modified Gompertz model. The system with a Sargassum spp.-OFMSW weight ratio of 33:67 allows to obtain a notable bio-methane volume of 327.27 ± 15.93 NmLg−1VS, ten times higher than from Sargassum spp. alone.

Revitalising small tourism destination states: necessity and strategies for structural change in tourism development

ABSTRACT This paper delves into the controversy surrounding the link between structural change and tourism development, particularly focusing on small tourism states, over the period 1995Q1–2020Q4 using a panel-based approach. To address the research objective, the Quantile-on-Quantile (QQ) regression approach is utilised to assess the impact of different quantiles of structural change on the quantiles of tourism development. To ensure robustness, the outcomes of the QQR approach are compared with those of the conventional quantile regression technique. Empirical findings from the QQR approach reveal nuanced relationships. In Belize, Cyprus, Dominican Republic, Iceland, Malta, and Seychelles, structural changes exhibit a structural-increasing effect on tourism development. Conversely, in the Bahamas, Fiji, and Trinidad & Tobago, structural changes manifest both structural-increasing and structural-decreasing effects on tourism development. In Bahrain, structural changes have a structural-decreasing impact on tourism development. Furthermore, the study establishes a feedback nexus between tourism and structural change, offering feasible policy suggestions for policymakers. Overall, the findings suggest that sound policy responses to the relationship between structural change and tourism development should be context-specific, responsive to changing dynamics, and aimed at maximising the positive impacts of structural changes while mitigating potential negative consequences.

Diagnosing the Causes of Failing Waste Collection in Belize, Bolivia, the Dominican Republic, Ecuador, Panama, and Paraguay Using Dynamic Modeling

Most developing countries fail to provide waste collection services to all their citizens, which leads to many adverse effects. Nevertheless, research has not yet succeeded in explaining the underlying causes. We drew up a quantitative system dynamics model that can be used to diagnose the complex societal system that is leading to poor waste collection. The model describes demographic, social, economic, financial, participatory, and governance processes that may play a role. It is calibrated against real-life datasets for six Latin American countries. The calibration shows adequate performance of the model. Strong population growth appears to have a dual effect. It leads to an increase in available budgets for collection but also tends to dilute the available budget per inhabitant. Processes on the growth of GDP, government revenues, and quality of governance strongly improve access of citizens to waste collection. They do so separately but also because they reinforce each other. But, there are differences per country. Progress in Belize seems to be hampered mostly by low governance quality. For Bolivia, the hurdle seems to consist of an inability to increase public revenues and absorb new urban citizens. Ecuador and Paraguay would also benefit from increased revenues along with an ability to increase public participation. The Dominican Republic and Panama reveal an overall passivity to improve their services. This model may be useful for decision makers globally to develop effective interventions.

Cetacean integration measures in MPA management plans in America

Marine Protected Areas (MPAs) are key strategies for marine conservation that strive to protect biological diversity and ensure the sustainable use of marine resources. Due to their wide distribution and mobility, cetaceans are exposed to numerous threats. Well-managed MPAs are one of the most effective tools in managing these threats to conserve cetaceans. This study aimed to analyze and compare the existing management approaches toward cetaceans from selected MPAs in the American continent. The purpose was to assess their primary failures and advances. To achieve this, ten MPAs that include at least one cetacean species as a focal conservation target were selected from 10 different countries: five in the Atlantic Ocean and five in the Pacific Ocean. The Marine Mammals Management Self-Assessment Toolkit was used to evaluate the integration of cetaceans in MPA management plans. This toolkit assigns scores to several subjects that are categorized into four themes: 1) Management Frameworks, 2) Addressing Activities and Threats, 3) Research and Monitoring, 4) Outreach and Engagement. Thereafter, a final percentage was obtained for each MPA. The Marine Mammal Sanctuary Bancos de la Plata y la Navidad in the Dominican Republic achieved the highest score. This MPA presented a specific plan to conserve marine mammals that includes zoning of environmentally sensitive areas and considers the threats and activities affecting marine mammals. The five MPAs with the lowest scores were from South America, with Cabo Polonio National Park (Uruguay) being the lowest, as its management plan does not include measures focused on cetaceans. In addition, a lack of monitoring in MPAs results in an absence of information on their impact on marine mammals. Addressing this shortcoming is of utmost importance for informing future MPA planning strategies. To conclude, this study highlights the importance of incorporating mitigation measures targeting priority species and underscores governance structures to regulate anthropogenic threats through robust legal frameworks and enforcement mechanisms.