Streptococcus pneumoniae, Staphylococcus aureus, and Klebsiella pneumoniae are the principal pathogens responsible for fatalities due to lower respiratory infections (LRIs), which pose a significant global health burden. During 2020 and 2021, the COVID-19 pandemic substantially altered the pathogenic landscape of LRIs. However, the specific impacts on S. pneumoniae, S. aureus, and K. pneumoniae have yet to be clearly determined. This study aims to analyze the changes in disability-adjusted life years (DALYs) associated with LRIs caused by these pathogens from 1990-2021, with a particular focus on the effects of the COVID-19 pandemic. We analyzed data on the DALY burden of LRIs attributable to S. pneumoniae, S. aureus, and K. pneumoniae from the Global Burden of Disease Study 2021, covering various geographic and demographic levels, including global, regional, national, age, and sex groups. To assess the overall trend, we calculated the estimated annual percentage change (EAPC) and used Joinpoint regression analysis to determine the annual percent change (APC) for local trends. Additionally, autoregressive integrated moving average (ARIMA) and Bayesian age-period-cohort (BAPC) models were utilized to forecast the age-standardized DALY rates (ASDRs) of the three pathogens through 2030. From 1990-2021, the ASDR for S. pneumoniae LRIs decreased the most significantly, dropping from 1249.50 per 100,000 population (95% UI: 1097.12-1415.86) in 1990 to 309.90 per 100,000 population (95% UI: 264.44-357.22) in 2021. In contrast, the ASDR for K. pneumoniae LRIs decreased from 281.51 per 100,000 population (95% UI: 242.56-321.31) in 1990 to 99.46 per 100,000 population (95% UI: 84.65-115.82) in 2021. S. aureus LRIs showed the slowest decline, with its ASDR decreasing from 242.89 per 100,000 population (95% UI: 216.69-270.69) in 1990 to 156.80 per 100,000 population (95% UI: 139.44-176.08) in 2021. East Asia experienced the most rapid decrease in the ASDR from 1990-2019 and was the only region with an increase during the COVID-19 pandemic (2019-2021). Pacific island nations, including Tokelau and Niue, experienced significant increases in ASDR during the pandemic. Vulnerable populations included children under five years of age and elderly individuals, with males facing a greater burden. Whereas the ASDR trends for S. pneumoniae LRIs and K. pneumoniae LRIs consistently declined, S. aureus LRI trends were irregular. The pandemic accelerated the reductions in ASDR for S. aureus LRIs and K. pneumoniae LRIs but slowed the decline in S. pneumoniae LRIs. By 2030, the ASDRs for these pathogens are projected to continue to decline, albeit at a slower pace for S. aureus LRIs. Over the past 32 years, public health initiatives targeting LRIs caused by S. pneumoniae and K. pneumoniae have significantly progressed, demonstrating effective control and management strategies. In contrast, the management of S. aureus LRIs remains less effective, indicating a need for enhanced focus and resources. The recurrent and increasing impact of S. pneumoniae LRIs during seasonal epidemics and pandemics highlights the urgency of prioritizing this pathogen in public health strategies. Despite the rising threat, the potential of S. aureus to become a leading cause of LRI-related DALY burden is often overlooked, underscoring the critical need for increased public health investment. Additionally, the public health infrastructure in small island nations is particularly vulnerable, emphasizing the need for targeted improvements to bolster their crisis management capabilities.

Caribbean Small Island Developing States (SIDS) are on the frontline of climate-induced coastal risks, where rising sea levels and intensifying storm surges converge with concentrated socioeconomic exposure. The inherent spatial constraints, economic dependency on tourism, and infrastructure clustering in coastal zones exacerbate systemic vulnerability. This study establishes an integrated high-resolution compound coastal risk framework by coupling hydrodynamic storm surge simulations with sea level projections and socioeconomic exposure data. The framework evaluates systemic risks across diverse return periods and Shared Socioeconomic Pathways including SSP1-1.9, SSP2-4.5, and SSP5-8.5, utilizing a modified static inundation model to integrate sea level rise and surge extremes for generating spatially explicit vulnerability assessments. Results revealed spatial heterogeneity and a distinctive ‘high-exposure–high-density–high-sensitivity’ configuration across several SIDS. Under SSP5–8.5, annual economic losses exceed USD 300 million in Jamaica and Cuba, and over 30,000 people may be affected in Dominica. Mitigation pathways consistent with a 1.5 °C warming limit (SSP1–1.9) reduce potential losses by 30–50%, while adaptation strategies, such as coastal ecosystem restoration and early-warning systems, deliver up to 40% carbon co-benefits. Beyond risk quantification, this framework supports climate-resilient infrastructure planning. By correlating spatial risks with adaptation finance, this research supports the Paris Agreement and Sustainable Development Goals (SDGs).

Comparison of Leptosira concentrations in two rivers within contrasting catchments in a leptospirosis hotspot.

Small Island Developing States (SIDS) such as Cabo Verde (CV) face persistent energy insecurity due to heavy reliance on imported fossil fuels and limited deployment of land-based renewables. This study develops a transferable, risk-informed multicriteria decision analysis (MCDA) framework for ocean current energy site selection, integrating high-resolution hydrodynamic modeling, environmental constraints, techno-economic factors, and tropical cyclone (TC) exposure. Using a high-resolution ocean circulation model that resolves tidal and inter-island flow dynamics, we characterize the spatial and temporal variability of surface currents and associated power densities across CV. These resource layers are combined with depth, distance-to-coast, protected areas, shipping routes, and TC hazard fields within an MCDA structure supported by sensitivity analysis. Results show that the strongest and most persistent currents occur within the northwestern inter-island channels, where seasonal mean speeds exceed 0.7m/s and power densities surpass 200 W/m2, with 95th-percentile speeds above 2m/s. Several locations meet key feasibility thresholds with mean currents near or above 1m/s, suitable depths (10-20m), proximity to shore, and relatively low variability while also lying outside high-TC-risk zones, low wave conditions, and major maritime corridors. The proposed framework demonstrates how hazard-aware, multi-criteria evaluation can support resilient OCE planning in SIDS and is transferable to other cyclone-exposed coastal systems.

Globalization has liberalized the flow of financial resources across national borders, creating numerous economic opportunities for small island developing countries, including Pacific Island countries. While the benefits of globalization are evident, it has also transformed the financial system into a prime target for money launderers and terrorism financiers. The fight against money laundering (ML) and terrorism financing (TF) has required substantial efforts from both developed and developing countries. Vanuatu is no exception. The Pacific Island countries (PICs) are currently experiencing intensifying geopolitical competition – what Comolli describes as the region becoming “a crowded space” of diplomatic, commercial and criminal interests – which suggests that the challenges of detecting and prosecuting money laundering and terrorist financing (ML/TF) are increasing exponentially. As the cases of ML/TF continue to rise, there are significant opportunities for Southern criminology to expand its global influence. The findings of this study confirm that ML/TF activities in Vanuatu contribute to the convergence of the Global North and South, as many of the ML/TF transactions involve both local and foreign entities. However, this convergence is not merely technical; it is deeply rooted in the political and structural factors increasingly shaping the criminal landscape, while local communities find themselves caught in the middle of these geopolitical machinations. However, Vanuatu’s ability to effectively identify, track, monitor and prosecute ML/TF cases is limited by a shortage of skilled professionals, including forensic investigators, litigation experts, computer engineers and lawyers. The findings of this study argue that addressing these limitations requires technical capacity alongside what Southern criminology terms “cognitive justice.”

Behavioural and social drivers of HPV vaccine uptake in Tonga: a mixed-methods study using the WHO BeSD framework and Talanoa in a Pacific Island setting.

ABSTRACT This paper examines how tourism development in small island destinations can be planned to balance economic growth, community well-being, and environmental sustainability. It employs a participatory simulation, implemented through a role-playing exercise, to explore how stakeholders negotiate tourism trade-offs under constrained conditions. Drawing on simulation sessions and qualitative interviews conducted on Hai Tac and Phu Quy islands in Vietnam, the study analyses how planning-relevant actors prioritise economic, environmental, and social concerns. The findings indicate that although growth-oriented options often attracted support, environmental protection, trust, and visitation management remained central to participants’ evaluations. At the same time, short-term economic priorities could outweigh longer-term social and ecological considerations. The PERMA framework was applied after inductive analysis as an interpretive lens for organising well-being-related themes. The study suggests that participatory simulation can support tourism planning by making stakeholder priorities, tensions, and trade-offs more explicit before decisions are institutionalised.

The small Pacific island nation of Niue was validated by the WHO in 2016 as having eliminated lymphatic filariasis (LF) as a public health problem; however, no post-validation surveillance (PVS) has been conducted since. In 2025, LF-PVS was integrated into a near-census national WHO STEPwise non-communicable disease (NCD) risk factor survey, a cost-effective approach for estimating LF prevalence and assessing whether elimination had been sustained. Finger-prick blood samples were tested for LF antigen and antibodies; antigen-positive samples were screened for microfilariae. One participant was antigen-positive (0.1%, 95% CI 0.02-0.88), and no microfilariae were detected, indicating sustained elimination. Ten participants were antibody-positive (five Wb123, four Bm14, one dual-positive). Semi-structured interviews provided operational insights, indicating that integrating LF-PVS into the WHO STEPwise NCD risk factor survey was resource-efficient, logistically feasible, and acceptable to both health workers and the community. This study is the first to examine the integration of NCD and communicable disease surveillance in the Pacific.

The first Turks and Caicos Islands global school health survey: Brief findings, challenges, lessons learned, and next steps

Global sensitivity analysis and scenario discovery reveal resilient water-energy system configurations on small islands under deep uncertainty

Cardiomyocytes show considerable heterogeneity in action potential duration (APD) throughout the ventricles. Based on canine experiments, it has been proposed that a population of cells exhibiting extremely long APDs, the M-cells, is present in the midmyocardium. This cell type continues to be used in simulation studies. In this review, however, we argue against including them in computer models of the ventricles. Our argument is based on experimental findings reported by other research groups who have looked for M-cells in several species. Other than in the canine wedge model, M-cells are neither found consistently in the same locations nor as a large band, but rather as sparse, small islands. Using computer simulations, we demonstrate that M-cells are not required to explain the electrocardiogram and that their inclusion may result in non-physiological behaviour. Finally, as initially proposed, M-cells only manifest prolonged APD at extremely slow pacing rates, below sinus rhythm, and would not be seen in arrhythmias. Therefore, we conclude that there is no proof of a large enough population of M-cells to affect transmural APD, nor is it necessary, so M-cells should not be included in computer models.

From urban heat island to thermal resilience: Lessons from low-cost microclimate monitoring in a small tropical island

Several small reservoir islands consistently support higher taxonomic, phylogenetic, functional, and interaction diversity than few large ones across multiple taxa

From categories to producers: Dual regulatory and Anthropocene-based classification of macrolitter on an uninhabited Caribbean island.

Sizing, economic analysis and optimisation of green hydrogen refuelling stations in a cluster of small islands

Escalating burden and spatial clustering of multidrug-resistant Pseudomonas aeruginosa in belize: A nationwide retrospective analysis, 2018–2024

This research adopts a model that has been developed around the Ecological Modernization and Resource Bless/Curse theories to offer practical insights on environmental sustainability. Data from 28 selected Caribbean and Latin American economies (grouped into 11 Small Island and Developing States (SIDSs) and 17 Large Continental Economies (LCEs)) for the period 2004 to 2024 is utilized in the analysis. ‘Method of Moments’ quantile regression and the two-stage least squares technique are employed for robust direct findings, while path analysis—a subset of structural equation modelling—is employed to examine the mediation and moderation relationships. Key findings shows that renewable energy is the key driver of sustainability in all Caribbean and Latin American economies regardless of the economy type. Consequently, digitalization and trade openness worsens environmental problems in the SIDSs. However, in the LCEs, digitalization advances sustainability up to a certain threshold, after which it becomes ineffective. Trade openness also tends to present a weak drive to sustainability in the LCEs. Green finance improves sustainability symmetrically in the SIDSs and asymmetrically in the LCEs as it only advances sustainability in highly environmentally stressed LCEs. The meditation role of green finance is significant in the SIDSs and insignificant in the LCEs, while the moderating role of institutional quality is insignificant in all Caribbean and Latin American economies. This study recommends channeling resources for supporting the development of green financial mechanisms for sustainable environments. Policy reforms that align economic efforts in advancing environmental sustainability can be adopted.

Wave energy is among the most promising renewable resources, but its widespread adoption has been constrained by its high levelized cost of electricity (LCoE). The dual use of wave energy converters (WECs) and wave farms for both coastal protection and renewable energy generation offers a promising pathway to lower costs while addressing coastal erosion. Despite this potential, no regional-scale assessment has yet examined the dual-use of WECs and wave farms in Caribbean Small Island Developing States (SIDS), where energy dependence and coastal erosion remain pressing challenges. This study develops a novel dual-use screening index to evaluate the combined potential of wave farms across four representative Caribbean SIDS: Barbados, Jamaica, St. Lucia, and The Bahamas. Long-term ERA5 wave data were used to estimate mean and maximum deep water wave power, while GEBCO bathymetry defined suitability zones (onshore, nearshore, offshore). Shelf area, wave power statistics, and zone-specific weights reflecting coastal protection benefits were combined into a standardized framework to enable cross-island comparison. Results highlight strong contrasts between islands: Barbados and St. Lucia exhibit wave power concentrated nearshore, suggesting strong dual-use potential, whereas Jamaica and the Bahamas trade lower wave energy resources for larger available shelf areas. The dual-use index highlights the most promising locations where energy generation and erosion mitigation can be jointly maximized. This study provides the first regional screening-level assessment of dual-purpose wave farms for Caribbean SIDS, combining wave resource indicators and coastal protection metrics to identify and rank candidate zones, introducing a transferable framework that links renewable energy potential with coastal protection benefits. The approach provides a foundation for future modelling, policy, and planning toward sustainable energy and coastal resilience, while offering actionable insights for Caribbean SIDS that advance both climate adaptation and progress toward the Sustainable Development Goals (SDGs). • First study to assess dual-use wave energy potential in Caribbean SIDS. • Integrated ERA5 wave data and GEBCO bathymetry for resource mapping. • Developed a novel dual-use screening index for energy and coastal protection. • Revealed new regional opportunities for coastal resilience and renewable energy. • Provides a foundation for future planning and SDG-aligned policies.

This study examines how governance and institutional support, infrastructure, human capital, technology and innovation, market access, community collective involvement, and sustainable environment contribute to agribusiness village performance in Tual City, Indonesia. Using PLS-SEM on survey data from 430 respondents across 30 villages, the analysis shows that governance functions as an indirect enabler rather than a direct driver of performance. Governance significantly strengthens market access, sustainable environment, technology adaptation, and community collective involvement, but its direct impact on performance is not significant. Market access emerges as the strongest determinant of performance, as value-chain connectivity allows producers to secure better prices and stabilize income. These findings align with global evidence that governance improvements initially enhance markets and coordination, thereby supporting sustainable livelihoods. Results are context-specific to small-island rural settings; further research should explore other socio-economic contexts. This study is the first to model the performance of fishery agribusiness villages in a small-island region.

ABSTRACT Small Island Nations face unique spatial and climatic challenges, yet the adaptive potential of compact urbanism in these settings remains underexplored. This study examines how compact urbanism can function as a climate adaptation strategy through a two-stage scenario evaluation model that positions perception as a critical mediator between urban form and adaptive capacity. Four AI-assisted spatial futures, ranging from dispersed to high-performance compact forms, were assessed through a national survey in Singapore (n = 400) and subsequently interpreted by expert panels in Bahrain (n = 23). Singaporean respondents consistently rejected dispersed urbanism, instead identifying three viable compact pathways shaped less by density itself than by microclimate quality, greenery, mobility coherence, and spatial familiarity. Bahraini experts reinterpreted these preferences through local climatic, institutional, and socio-cultural conditions, revealing that compactness becomes “conditioned rather than preferred,” feasible only when aligned with privacy norms, governance capacity, and incremental retrofit logic. The study reframes compact urbanism as a context-dependent adaptation strategy and demonstrates how perception and institutional conditions mediate its feasibility across contrasting island systems. It further introduces a transferable evaluation approach linking public and expert perspectives, while highlighting the need for calibration to local cultural, climatic, and governance contexts.