English-speaking Caribbean Countries Research Articles

Understanding mental health conditions and key coping strategies utilized during major lockdowns in the Caribbean based on Google trends searches

The COVID-19 pandemic has prompted countries to implement extended Shelter in Place Orders (SIPOs) to restrict population movement and mitigate community spread. While these lockdown measures may be effective in containing the virus, they can substantially impact the population's well-being, potentially undermining their overall welfare. This study investigates whether major lockdowns implemented in the Caribbean produced differential changes in mental health among key English-Speaking Caribbean countries. More importantly, unlike past studies, we examine key coping strategies persons utilize during major lockdowns. Finally, this paper utilizes a novel near real-time high-frequency data source in Google Trends data analytics to assess mental health patterns and coping strategies among major Caribbean countries. Based on the results of difference-in-difference and event study models, we find positive and significant increases in searches for fear, depression, and suicide during key lockdown periods, which suggest negative mental health effects. Regarding coping strategies, searches for Zoom, learning, books, exercise, prayer, religion, and meditation increased, together with searches for addiction and marijuana. These results indicate the types of programs health administrators and policymakers can implement during lockdown periods to help local mental health communities, particularly among island communities.

Validating Social Control, Self-Control, and Social Learning Constructs Among a Sample of Youth in Nine English-Speaking Caribbean Nations

Measures in international self-report surveys drawn from criminological theories have rarely been validated. Instruments that have been tested suggest that they might lack reliability and validity depending on the nation. The present study uses a large sample of school-attending youth in nine English-speaking Caribbean countries to examine the reliability and validity of three theoretical constructs—social control, self-control, and social learning—included in the Eurogang Youth Survey instrument. Our findings suggest that the theoretical constructs contained in the Eurogang Youth Survey instrument are relevant to explaining Caribbean delinquency and show adequate reliability levels. Our results also show consistency in the measurement structure of these theoretical constructs across the study nations.

Surgical training in the Caribbean: The past, the present, and the future.

The six million inhabitants of these diverse English-speaking Caribbean countries are grateful to the University of the West Indies, which has been central in the independent training of surgical specialists in all areas of surgery for the past 50 years. Similar to the per capita income, the quality of surgical care, albeit acceptable, is quite variable throughout the region. Globalization and access to information have revealed that the quality of training and surgical care being delivered can be further improved. Technological advances will perhaps never be on par with higher-income countries, but collaborative ventures with global health partners and institutions can ensure that the people of the region will have appropriately trained surgical doctors and, therefore, the provision of accessible quality care will remain a staple, with even the possibility of income generation. This study reviews the journey of our structured surgical training program delivered in the region and outlines our growth plans.

READ-ing antimicrobial stewardship in the Caribbean: a tri-nation document review.

To explore the antimicrobial stewardship policy landscape in three English-speaking Caribbean countries (Barbados, Guyana, and Saint Lucia) and examine the key enablers and challenges to the design and implementation of formal antimicrobial stewardship programs. A document analysis that searched for existing policy, communications, and contributions on antimicrobial stewardship from these three countries, adapting the READ (Ready materials; Extract data; Analyze data; Distill findings) approach, a systematic procedure for health policy document review. The search strategy identified 726 initial records. Of those, 15 (2%) met the inclusion criteria. The analysis included official policy documents (n = 3), scholarly works/reviews (n = 3), advocacy documents (n = 2), news articles (n = 4), and confidential reports (n = 3) from the three countries. Critical matters such as cross-programmatic coordination, the significance of individual action, and the need for bidirectional knowledge discourse are prominent in optimizing antimicrobial stewardship adaptation in these countries. CARICOM regional coordination has positively impacted the integration of infection prevention and control with antimicrobial stewardship across this knowledge network.

A Bibliometric Analysis of COVID-19 Scientific Literature From the English-Speaking Caribbean.

The COVID-19 pandemic has led to a global crisis and has affected the Caribbean islands,leading tosignificant health and socioeconomic consequences in this region. Efforts to mitigate the burden of this disease have led to an accelerated amount of research in the English-speaking Caribbean (ESC).This bibliometric analysisaimedto evaluate the COVID-19-related scientific literature from the ESC nations. A total of 175 articles were included and analyzed froman initialPubMed search (n = 638) for COVID-19-related scientific literature from the ESC nations published between January1, 2020, and June 30, 2022.Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington) and the VOSviewer (version 1.6.18)were used to characterize countries, authorship, journals, affiliations, and keywords of the COVID-19-related articles. Trinidad and Tobago (38%), Jamaica (22%), Barbados (20%), and Grenada (15%) contributed to the greatest number of publications. The University of the West Indies (UWI) campuses in Trinidad and Tobago, Jamaica and Barbados, and St. George's University in Grenada were the most prolific institutions. Srikanth Umakanthan from the UWI was the most prolific author. Cureus, SN Comprehensive Clinical Medicine, and Frontiers in Public Health were the first three most productive journals; 59% of the 175 articles had either the first or last author affiliated with an institution in the ESC, and 19% of the articles were country-focused: Trinidad and Tobago (16/175), Jamaica (9/175), Barbados (5/175), and Antigua and Barbuda (2/175). Among the top themes of research, 27% were outbreak response and rearrangements, epidemiological studies (23%), clinical management (23%), and medical education (13%). Over the last two years, an interest stimulated by the pandemic has expanded the research in ESC countries. However, gaps in the knowledge exist, especially in the epidemiology of COVID-19 complications in the sub-populations of chronic non-communicable diseases, post-COVID syndrome, and the long-COVID syndrome in the region. Hence, there is enormous scope for more research across the region.

Evaluation of Bisphenol A in Pregnant Women from 10 Caribbean Countries.

Bisphenol A (BPA), a phenolic chemical incorporated into many plastic products, has been found to act as an endocrine disruptor that potentially is linked to adverse neurodevelopmental outcomes. Prenatal BPA concentration levels were assessed in 10 English-speaking Caribbean countries by randomly selecting 15 maternal urine samples from approximately 50 pregnant women samples collected in each island and then comparing the findings with comparable data from Canada and the U.S. BPA was detected in all samples ranging from a low geometric mean of 1.46 μg/L (St. Lucia) to a high of 4.88 μg/L (St. Kitts & Nevis). All of the Caribbean islands sampled had geometric mean concentration levels that were higher than those recorded in two Canadian biomonitoring surveys (1.26 μg/L and 0.80 μg/L) and the U.S. NHANES survey (1.39 μg/L). This first biomonitoring survey of BPA concentration levels in maternal urine samples taken from Caribbean countries clearly points to the need for Caribbean governments and public health officials to first engage in legislative and regulatory efforts to ban or minimize the importation and use of BPA products used the Caribbean and, second, to continue to conduct biomonitoring surveys so as to ensure that these laws and regulations are indeed leading to a decrease of BPA concentrations in Caribbean populations.

Los implantes cocleares en América latina

Los implantes cocleares en América latina

Caribbean small ruminant importation requirements in an era of widespread anthelmintic resistance.

Resistance of small ruminant gastrointestinal parasites to available classes of anthelmintic drugs is a widespread problem. As such, use of these drugs needs to be applied in a judicious manner in order to protect animal health. Herein, a case of drug-resistant gastrointestinal nematodes imported to the Cayman Islands is outlined. In order to explore the potential for similar occurrences within the region, a survey was undertaken in March 2017 to assess the importation requirements for small ruminants to English-speaking Caribbean countries. The survey showed that universal administration of anthelmintics to small ruminants is a common pre-requisite for importation to the Caribbean region, though very few countries require any proof of drug efficacy. Such requirements are discordant with current recommendations for judicious anthelmintic use in domestic animal species and promote the continued development of anthelmintic resistance. While this survey focused on small ruminants, similar policies are often in place for the importation of a variety of animal species, including cattle, horses, and companion animals. Given that anthelmintic resistance is also recognized in parasite populations that impact these species, it may be time for the international community to revisit live animal importation requirements in the age of anthelmintic resistance. Some recommendations and considerations are put forward to help preserve animal health, animal welfare, and developing animal agricultural industries.

Policy responses to reduce single-use plastic marine pollution in the Caribbean

Caribbean economies depend heavily on a healthy marine ecosystem, but the region includes ten of the top global marine polluters per capita. Regional marine pollution is driven by illegal plastic waste dumping due to poor waste management systems with limited recycling, and weak enforcement. Governments recognize the impacts of marine debris on their social and economic well-being and have responded with policies to curb plastic pollution. Most focus on bans of single-use plastic and polystyrene, which comprises ~80% of Caribbean marine litter. However, there is little comparative analysis of policy responses to determine their efficacy. This paper reviews current policies in 13 English-speaking Caribbean countries, exploring tools used and process of implementation. Eleven have introduced legislative policies, with seven including fines and penalties for non-compliance. All successful policies involve multiple tools, including primary stakeholder engagement, sufficient lead time between policy announcement and implementation, and extensive public education campaigns.

Suicide Prevention intheAmericas.

The Americas encompass the entirety of the continents of North America and South America, representing 49 countries. Together, they make up most of Earth's western hemisphere. The population is over 1 billion (2006 figure), with over 65 % living in one of the three most populated countries (the United States, Brazil, and Mexico). The Americas have low-, middle-, and high-income countries. Data from this region have not been readily and consistently available. There are several English-speaking Caribbean nations and countries in South America that have not had updated information. This chapter will focus on suicide prevention within North America (United States and Canada), some countries in the Caribbean region, and some countries in South America. Guyana, Suriname, and Trinidad and Tobago have severe issues with pesticide suicide, with average rates of 44.2 (global rank 1); 27.8 (global rank 5) and 13.0 (global rank 41) per 100,000 respectively. Jamaica, however, had one of the lowest rates: 1.2 per 100,000 (global rank 166). General, regional, and country-specific prevention proposals are suggested, highlighting intersectoral, private collaboration, attention to at-risk persons, substance abuse and mental health interventions, training, and reducing access to lethal means.

Construct validity and reliability of the Talent Development Environment Questionnaire in Caribbean youth track and field athletes.

Caribbean nations stand to benefit significantly from the potential insights that can be gained from the assessment of their athlete talent development environments; which in turn can lead to the formulation of evidence-based strategies and improvements to their sport development pathways. The principal aim of this study was to examine the psychometric properties of the 25-item TDEQ-5 to determine its validity to assess the development environments of talented youth track and field athletes from six English-speaking Caribbean countries. As a secondary aim, we sought to examine athletes’ perceptions of their talent development environment within this context. Confirmatory factor analysis revealed adequate model fit of a re-specified model and good overall internal reliability of the scale, therefore offering support for its use within this context. Furthermore, adequate construct validity and internal reliability was found within three subscales (i.e., communication, holistic quality preparation and support network) with subpar scores within two subscales (i.e., long-term development focus and alignment of expectations). Preliminary findings on athletes’ perceptions of their environment revealed key strengths in coaches’ long-term development focus and communication, however deficiencies were noted in the accessibility and availability of sport-related support and preparation of athletes. In conclusion, the re-specified TDEQ-5 with 25 items appears to be a reliable and valid measure within the Caribbean context. However, it is recommended that the scale be used with some caution with regard to the interpretation of results for the ‘long-term development focus’ and ‘alignment of expectations’ subscales.

Baseline characteristics and outcomes of children with cancer in the English-speaking Caribbean: A multinational retrospective cohort.

English-speaking Caribbean (ESC) childhood cancer outcomes are unknown. Through the SickKids-Caribbean Initiative (SCI), we established a multicenter childhood cancer database across seven centers in six ESC countries. Data managers entered patient demographics, disease, treatment, and outcome data. Data collection commenced in 2013, with retrospective collection to 2011 and subsequent prospective collection. A total of 367 children were diagnosed between 2011 and 2015 with a median age of 5.7 years (interquartile range 2.9-10.6 years). One hundred thirty (35.4%) patients were diagnosed with leukemia, 30 (8.2%) with lymphoma, and 149 (40.6%) with solid tumors. A relative paucity of children with brain tumors was seen (N=58, 15.8%). Two-year event-free survival (EFS) for the cohort was 48.5% ± 3.2%; 2-year overall survival (OS) was 55.1% ± 3.1%. Children with acute lymphoblastic leukemia (ALL) and Wilms tumor (WT) experienced better 2-year EFS (62.1% ± 6.4% and 66.7% ± 10.1%), while dismal outcomes were seen in children with acute myeloid leukemia (AML; 22.7 ± 9.6%), rhabdomyosarcoma (21.0% ± 17.0%), and medulloblastoma (21.4% ± 17.8%). Of 108 deaths with known cause, 58 (53.7%) were attributed to disease and 50 (46.3%) to treatment complications. Death within 60 days of diagnosis was relatively common in acute leukemia [13/98 (13.3%) ALL, 8/26 (30.8%) AML]. Despite this, traditional prognosticators adversely impacted outcome in ALL, including higher age, higher white blood cell count, and T-cell lineage. ESC childhood cancer outcomes are significantly inferior to high-income country outcomes. Based on these data, interventions for improving supportive care and modifying treatment protocols are under way. Continued data collection will allow evaluation of interventions and ensure maximal outcome improvements.

WHO Mental Health Gap Action Programme implementation in the Small Island Development States: experience from the Pacific and English-speaking Caribbean countries.

Owing to the relatively small population sizes and remoteness of the Small Island Development States (SIDS), their mental health systems face many common difficulties. These include having few mental health specialists per country, limited access to mental health services and low awareness. To overcome these limitations, the World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP), which aims to decrease the treatment gap by training non-specialists, was implemented in more than 20 Pacific and English-speaking Caribbean countries. Many lessons were learnt from the experience. Mental health specialist support is crucial, and online training and supervision could be a solution. mhGAP training proved to be effective to improve knowledge and attitude, but close monitoring and supervision are needed to change clinical practice. Awareness raising and mental health service capacity building need to occur simultaneously. To realise sustainable development goals, countries need to invest more in mental health, especially in human resources; mhGAP will be one effective solution.

Long-term epidemiological dynamics of dengue in Barbados - one of the English-speaking Caribbean countries.

Using the dengue surveillance program, we prospectively collected data on all the suspected and confirmed cases of dengue in Barbados from 2006 to 2015. Data were analysed for demographic, seasonal and temporal dynamics of this disease in this country. The overall mean annual incidence rate of suspected and confirmed dengue over the study period was 0.49% (range 0.15%-0.99%) and 0.16% (range 0.05%-0.48%), respectively. There was a significant correlation between the mean monthly number of confirmed cases, the mean monthly rainfall and the mean monthly relative humidity percentage. Dengue in this population is predominantly an infection affecting children and young adults. The median age of the patients with both, suspected and confirmed dengue was 25 years and the highest proportion of cases was seen in the age group 0-15 years. The annual incidence rates of both the suspected and the confirmed cases showed an upward trend during the study period and this upward trend was more pronounced among children.

Innovation Implementation by SMEs in Trinidad and Tobago

Innovation has become an important contributing factor to firms’ competitive advantage. However, little research has been carried out in understanding innovation in small and medium-sized enterprises in the English-speaking Caribbean countries, particularly in Trinidad and Tobago. This study evaluates the degree to which small and medium-sized enterprises in Trinidad and Tobago engage in innovative activities within their businesses’ operations and identifies the major barriers to innovation that are experienced by these firms. This exploratory study utilized primary data collected through delivery and collection survey questionnaires from 350 randomly selected small and medium-sized enterprises with a minimum active operation period of five years in Trinidad and Tobago. The questionnaire, administered to the longest serving employees of the small and medium-sized enterprises, was designed to collect information on each small and medium-sized enterprise about their innovation experiences, the innovative environment, and innovation barriers. Some of the variables measured were adapted from the Community Innovation Survey found in previous research done by Sileshi Talegeta (2014). The key findings from the research revealed that there are limited efforts of small and medium-sized enterprises in Trinidad and Tobago to implement strategies for encouraging innovation within their organizations. More specifically, it was found that there are low levels of product innovation, process innovation, marketing innovation, and organizational innovation in small and medium-sized enterprises in Trinidad and Tobago. The data suggested that the main barriers to innovation present in small and mediumsized enterprises in descending order of intensity are as follows: organizational culture, lack of reward and recognition, lack of finance, lack of skilled personnel, and lack of knowledge, lack of co-operation, market barriers, and legal barriers. The conclusion from the research findings showed that internal and external factors hindered the small and mediumsized enterprises in Trinidad and Tobago innovation capabilities

Prevalence of high-risk human papillomavirus among women in two English-speaking Caribbean countries

ABSTRACTObjective.To characterize high-risk human papillomavirus (HPV) infections in a sample of women in two small English-speaking Caribbean countries: Saint Kitts and Nevis and Saint Vincent and the Grenadines.Methods.Sexually active women ≥ 30 years old attending primary care health facilities participated in the study. Each participant had a gynecological examination, and two cervical specimens were collected: (1) a specimen for a Papanicolaou (Pap) test and (2) a sample of exfoliated cervical cells for HPV DNA testing, using the HPV High Risk Screen Real-TM (Sacace). High-risk HPV genotypes were assessed in 404 women in Saint Kitts and Nevis and 368 women in Saint Vincent and the Grenadines.Results.High-risk HPV was detected in 102 of 404 (25.2%) in Saint Kitts and Nevis and in 109 of 368 (29.6%) in Saint Vincent and the Grenadines. High-risk HPV genotypes 52, 35, 51, 45, and 31 were the most common high-risk types in Saint Kitts and Nevis. In Saint Vincent and the Grenadines, the most common high-risk HPV genotypes were 45, 35, 31, 18, and 51. Current age was found to be significantly associated with high-risk HPV infection in both countries. In addition, in Saint Vincent and the Grenadines, high parity (> 3 pregnancies) and having had an abnormal Pap smear were found to be independent risk factors for high-risk HPV.Conclusions.These results contribute to the evidence on HPV prevalence for small island states of the Caribbean and support the accelerated introduction of the 9-valent HPV vaccine in the two countries and elsewhere in the English-speaking Caribbean. Use of the study’s results to guide the development of policy regarding implementation of HPV testing as the primary screening modality for older women is recommended.

Toward a Simplified Software Process Improvement Framework for Small Software Development Organizations

ABSTRACTFor decades, software developers have struggled with delivering high-quality systems. To address the issues related to poor quality software, many use software process improvement (SPI) models such as the capability maturity model integration (CMMI) to guide the software development process. However, implementing these initiatives in small software development organizations is particularly challenging due to the high cost and complexity involved. To address these issues, this study proposes a simplified SPI framework (based on the CMMI) that small organizations can use to help improve software development. Conducted in four English-speaking Caribbean countries, this study uses focus groups with information systems (IS) professionals to arrive at a consensus on the content of a simplified SPI model. The model was assessed using data from a survey of small software development organizations’ practices across the four countries. The resulting model, called the SPI model for small organizations (SPIM-S) is deemed less cumbersome and complex to implement, in comparison to its counterpart, the CMMI. It should therefore be less disruptive to implement—offering practitioners an alternative guide in their quest for high-quality software.

The right to free movement of persons in Caribbean community (CARICOM) law: towards 'juridification'?

The Caribbean Community and Common Market (CARICOM) is one of the oldest, and arguably one of the most successful, regional organisations in the Commonwealth today. Influenced in large part by the European model of regional integration, CARICOM has, since the early 1970s, sought to progressively engage its constituent member states – for the most part English-speaking Caribbean countries – on a number of important developmental issues, such as the trade in goods and the free movement of services and capital. In more recent years, the free movement of persons has come to the fore. It is important to note that the process by which CARICOM has progressively achieved this particular (and important) goal has not been straightforward, fraught as it has been with a number of practical and institutional difficulties, many of which still continue today, notwithstanding what can be described as the recent trend towards the ‘juridification’ of the right to free movement in CARICOM law. Since this issue has not been adequately addressed in existing literature, this article provides a nuanced analysis of the extent to which the right to free movement of persons in CARICOM law has ‘juridified’, by reference to the theory of ‘juridification’, as posited by Spiros Simitis and Jon Clarke among others.

Toxoplasmosis in the Caribbean islands: literature review, seroprevalence in pregnant women in ten countries, isolation of viable Toxoplasma gondii from dogs from St. Kitts, West Indies with report of new T. gondii genetic types

Little is currently known of clinical toxoplasmosis in humans and animals in the Caribbean. We investigated the prevalence of IgG and IgM antibodies in 437 pregnant women from 10 English speaking Caribbean countries. Overall, antibodies (IgG) to Toxoplasma gondii (modified agglutination test, MAT, cut-off 1:6) were found in 174 (39.8 %) of 437 human sera; specifically 12 of 38 from Antigua-Barbuda, 26 of 52 from Belize, 9 of 50 from Bermuda, 29 of 49 from Dominica, 18 of 49 from Grenada, 16 of 47 from Jamaica, 5 of 15 from Montserrat, 8 of 44 from St. Kitts/Nevis, 24 of 45 from St. Lucia, and 27 of 50 from St. Vincent/Grenadines were seropositive. All IgG-positive sera were tested for IgM antibodies using the immunocapture method; all sera were negative for IgM antibodies. Additionally, tissues and sera of 45 dogs from St. Kitts were examined for T. gondii infection. Antibodies (IgG, MAT, 1:≥25) were found in 19 (42.2 %) of 45 dogs. Muscle samples (tongue, leg) of 19 seropositive dogs were digested in pepsin, and homogenates were bioassayed in mice. Viable T. gondii were isolated from 6 dogs. T. gondii isolates were further propagated in cell culture. PCR-RFLP genotyping of cell culture derived tachyzoites using 10 genetic markers, SAG1, SAG2 (5' and 3' SAG2, and alt.SAG2) SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico revealed that 4 isolates were ToxoDB PCR-RFLP genotype #2, and 2 were new genotypes #264 and #265. Review of 22 viable T. gondii isolates from chickens, dogs, and cats from Grenada and St. Kitts revealed that 1 isolate was type II, 13 were type III, and 8 were atypical. Thus, type III strains were predominant. Overall, the study revealed high prevalence of T. gondii in the Caribbean islands.

Epilepsy care in the southern Caribbean.

Very little has been reported about the health resources available for patients with epilepsy in the five English-speaking southern Caribbean countries of Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia. There is no comprehensive resource describing their health systems, access to specialty care, antiepileptic drug (AED) use, and availability of brain imaging and EEG. The purpose of this study was to profile epilepsy care in these countries as an initial step toward improving the standard of care and identifying gaps in care to guide future policy changes. In each southern Caribbean country, we conducted study visits and interviewed health-care providers, government health ministers, pharmacy directors, hospital medical directors, pharmacists, clinic staff, radiologists, and radiology and EEG technicians. Health-care providers completed extensive epilepsy care surveys. The five countries all have integrated government health systems with clinics and hospitals that provide free or heavily subsidized care and AEDs for patients with epilepsy. Only Trinidad and Tobago and Barbados, however, have neurology specialists. The three smaller countries lack government imaging and EEG facilities. Trinidad had up to one-year waits for public MRI/EEG. Government formularies in Grenada, Saint Vincent and the Grenadines, and Saint Lucia are limited to first-generation AEDs. One or more second-line agents are formulary in Trinidad and Barbados. Nonformulary drugs may be obtained for individual patients in Barbados. Grenada, Saint Lucia, and Saint Vincent and the Grenadines participate in an Organization of Eastern Caribbean States formulary purchasing system, which added levetiracetam following the survey. Newer generic AED formulations with the lowest risks for pregnancy malformation were not in use. In conclusion, patients with epilepsy in the southern Caribbean have excellent access to government clinics and hospitals, but AED choices are limited. Local medical providers reported that the major limitations in care were lack of specialty care, lack of imaging and EEG services, financial barriers to care, long wait times for care, and limited access to additional AEDs.