US Virgin Islands Research Articles

Development of an HIV/STI and partner violence health promotion intervention for abused US Virgin Islands women.

Women in the US Virgin Islands (USVI) experience intimate partner violence (IPV) and human immunodeficiency virus (HIV) at disproportionate rates compared to women on the US mainland. Women in violent relationships report experiencing controlling behaviours that decrease their ability to negotiate for sex using condoms or to prevent unwanted pregnancies. Though several evidence-based interventions exist to prevent either IPV or HIV, few address them through an integrated health promotion approach or attend to particular USVI cultural mores. This article describes the systematic development of a theory based, culturally tailored, integrated health promotion intervention that addresses IPV and HIV among USVI women experiencing abuse. The process included: (i) identifying and integrating evidence-based health promotion interventions, (ii) conducting formative research using focus groups, (iii) synthesizing focus group data to inform intervention development and (iv) developing a culturally and linguistically appropriate intervention specific to the needs and concerns of USVI women. The Empowered Sisters Project: Making Choices Reducing Risks (ESP) was developed through this research. ESP is a three-session health promotion curriculum focussed on enhancing sexual health and safety among women experiencing abuse. The ESP intervention components included promoting condom use, increasing IPV and HIV knowledge and developing a personalized safety plan. Health professionals facilitated individual intervention sessions using culturally tailored visual media and scripts. This program focussed on experiences of women living in the USVI and has implications for utility across the Caribbean diaspora.

Urbanization driving Ocypode quadrata burrow density, depth, and width across Caribbean beaches

Globally, sandy beaches support local economies and are the most commonly-used type of coastline. This importance is perhaps most striking in the Caribbean; however, no study has assessed the morphological features of the U.S. Virgin Islands (USVI) sandy beaches or evaluated how their biodiversity is influenced by human activities. We addressed these gaps by sampling eight St. Thomas, USVI, beaches with different urbanization levels (Stumpy Bay, Santa Maria Bay, Caret Bay, Neltjeberg Bay, Lindberg Bay, Magens Bay, Coki Point Beach, and Sapphire Beach) multiple times during high- and low-tourist season. At each sampling site and occasion, we measured environmental features (i.e., grain size, waves, and slope), urbanization variables (e.g., solid waste, traffic of vehicles, and beach cleaning) and ghost crab (Ocypode quadrata) population parameters (i.e., burrow density, depth, and width). We found that all studied beaches have similar morphodynamic features, being generally characterized as wave dominated reflective. Urbanization variables were the main drivers of ghost crab populations, with visitor frequency, distance to urban center, and evidence of vehicles on sand exerting stronger roles than variations in physical beach characteristics. Overall, our results provide important information on the morphology of USVI beaches and the impact of beach use. We expect these results will increase understanding of the drivers and threats to local sandy beach biodiversity, inform future management decisions for the territory, while creating a baseline for ghost crab studies in the U.S. Virgin Islands.

Epidemiologic Trends of Dengue in U.S. Territories, 2010-2020.

Dengue is one of the most common vectorborne flaviviral infections globally, with frequent outbreaks in tropical regions. In 2019 and 2020, the Pan American Health Organization reported approximately 5.5 million dengue cases from the Americas, the highest number on record. In the United States, local dengue virus (DENV) transmission has been reported from all U.S. territories, which are characterized by tropical climates that are highly suitable for Aedes species of mosquitoes, the vector that transmits dengue. Dengue is endemic in the U.S. territories of American Samoa, Puerto Rico, and the U.S. Virgin Islands (USVI). Dengue risk in Guam and the Commonwealth of the Northern Mariana Islands is considered sporadic or uncertain. Despite all U.S. territories reporting local dengue transmission, epidemiologic trends over time have not been well described. 2010-2020. State and territorial health departments report dengue cases to CDC through ArboNET, the national arboviral surveillance system, which was developed in 2000 to monitor West Nile virus infections. Dengue became nationally notifiable in ArboNET in 2010. Dengue cases reported to ArboNET are categorized using the 2015 Council of State and Territorial Epidemiologists case definition. In addition, DENV serotyping is performed at CDC's Dengue Branch Laboratory in a subset of specimens to support identification of circulating DENV serotypes. During 2010-2020, a total of 30,903 dengue cases were reported from four U.S. territories to ArboNET. Puerto Rico reported the highest number of dengue cases (29,862 [96.6%]), followed by American Samoa (660 [2.1%]), USVI (353 [1.1%]), and Guam (28 [0.1%]). However, annual incidence rates were highest in American Samoa with 10.2 cases per 1,000 population in 2017, followed by Puerto Rico with 2.9 in 2010 and USVI with 1.6 in 2013. Approximately one half (50.6%) of cases occurred among persons aged <20 years. The proportion of persons with dengue who were hospitalized was high in three of the four territories: 45.5% in American Samoa, 32.6% in Puerto Rico, and 32.1% in Guam. In Puerto Rico and USVI, approximately 2% of reported cases were categorized as severe dengue. Of all dengue-associated deaths, 68 (0.2%) were reported from Puerto Rico; no deaths were reported from the other territories. During 2010-2020, DENV-1 and DENV-4 were the predominant serotypes in Puerto Rico and USVI. U.S. territories experienced a high prevalence of dengue during 2010-2020, with approximately 30,000 cases reported, and a high incidence during outbreak years. Children and adolescents aged <20 years were disproportionately affected, highlighting the need for interventions tailored for this population. Ongoing education about dengue clinical management for health care providers in U.S. territories is important because of the high hospitalization rates reported. Dengue case surveillance and serotyping can be used to guide future control and prevention measures in these areas. The Advisory Committee on Immunization Practices recommends vaccination with Dengvaxia for children aged 9-16 years with evidence of previous dengue infection and living in areas where dengue is endemic. The recommendation for the dengue vaccine offers public health professionals and health care providers a new intervention for preventing illness and hospitalization in the age group with the highest burden of disease in the four territories (Paz Bailey G, Adams L, Wong JM, et al. Dengue Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recomm Rep 2021;70[No. RR-6]). American Samoa, Puerto Rico, and USVI are all considered endemic areas and persons residing in these areas are eligible for the new dengue vaccine. Persons aged 9-16 years in those jurisdictions with laboratory evidence of previous dengue infection can receive the dengue vaccine and benefit from a reduced risk for symptomatic disease, hospitalization, or severe dengue. Health care providers in these areas should be familiar with the eligibility criteria and recommendations for vaccination to reduce the burden of dengue among the group at highest risk for symptomatic illness. Educating health care providers about identification and management of dengue cases can improve patient outcomes and improve surveillance and reporting of dengue cases.

Thermoluminescence and radiocarbon dating of pre-colonial ceramics and organic midden material from the US Virgin Islands: outline for a revised chronology

A sample of 128 pottery shards curated by the National Museum of Denmark, from seven archaeological sites in the US Virgin Islands, has been dated using the thermoluminescence dating (TL) technique with the purpose of refining local pre-colonial pottery chronology. The results of the TL-dating generally confirm chronologies offered by Wild for St. John and there is considerable variation identified in traditional frameworks due to overlap in distributions of various pottery styles. The results of this study show that the Virgin Islands offer a viable space for the application of TL-dating, and that TL-dating offer a reliable addition to the traditional radiometric radiocarbon technique in pre-colonial midden contexts. Using the TL-technique for dating of pottery assemblages allows for a nuanced chronology and better understanding of settlement timing, socio-cultural interaction, and information transmission.Graphical

Semi-analytical inversion modelling of Chlorophyll a variability in the U.S. Virgin Islands

Coral reef health in the U.S. Virgin Islands (USVI) is in decline due to land-based sources of pollution associated with watershed development and global climate change. Water quality is a good indicator of stress in these nearshore environments as it plays a key role in determining the health and distribution of coral reef communities. Conventional water quality assessment methods based on in situ measurements are both time consuming and costly, and they lack the spatial coverage and temporal resolution that can be achieved using satellite remote sensing techniques. Water quality parameters (WQPs) such as Chlorophyll a (Chl-a), can be studied remotely using models that account for the inherent optical properties (IOPs) of the water. In this study, empirical based standard ocean color algorithm (OC4) and two semi-analytical algorithms, the Garver–Siegel–Maritorena (GSM) and the Generalized Inherent Optical Properties (GIOP) model, were evaluated in retrieving Chl-a in the nearshore waters of the USVI. GSM and GIOP were also evaluated for modeling inherent optical properties such as absorption coefficient of phytoplankton (aph (443)). Analysis of the results from each model using a field database from six cruises during May/June and December between 2016 and 2018, showed that the OC4 performed poorly with R2 of 0.14 and RMSE = 0.15. Effects of suspended particulates and benthic reflectance most likely contributed to the poor performance of the algorithm. GSM is a slightly better estimator for aph (443) and Chl-a (R2 = 0.55, RMSE = 0.04; R2 = 0.60, RMSE = 0.09) than GIOP (R2 = 0.52, RMSE = 0.05; R2 = 0.17, RMSE = 0.15). Performance of the semi-analytical models are limited in estimating particulate back scattering (bbp (443)) also due to the benthic albedo effects in the shallow waters. The calibrated GSM model was applied to Landsat 8 OLI satellite imagery spanning 2016–2018 to develop a time series of the spatial changes in Chl-a concentrations in the coastal waters of the USVI. The Landsat GSM Chl-a model produced promising results of R2 = 0.45, RMSE = 0.07, in an environment where signal-to-noise ratio is significantly low.

Decline in Fire Ants (Hymenoptera, Formicidae, Solenopsis spp.) Along an Important Sea Turtle Nesting Beach at Sandy Point National Wildlife Refuge, St Croix, US Virgin Islands

Two species of fire ants, Solenopsis geminata (Fabricius) and Solenopsis invicta (Buren), pose important threats to sea turtles, attacking hatchlings both within the nest and as they emerge and head towards the ocean. We surveyed ants at permanent markers along a major sea turtle nesting beach at Sandy Point National Wildlife Refuge, Saint Croix, US Virgin Islands, where both S. geminata and S. invicta occur. Over the course of five surveys in 2006, 2010, 2014, 2018, and 2022, the percent of tuna baits with S. geminata or S. invicta present declined from 48% in 2006, to 30%, 16%, 2%, and 4% in the four subsequent surveys. The reasons for the decline in fire ants on this beach are uncertain, but it is likely a positive development for nesting sea turtles.

Quantitative Analysis of United States National Guard COVID-19 Disaster Relief Activities April-June 2020

Introduction:The COVID-19 pandemic provided a unique opportunity for the United States National Guard (NG) to assist in an infectious disease disaster. This study aims to interpret data from NG situation reports (SITREPS) given to the National Guard Bureau (NGB) by each state national guard headquarters regarding their relief efforts from April to June 2020. This is the first published study about NG disaster relief utilizing quantitative data provided by the US military.Method:The SITREPS of all 50 states, the District of Columbia, Guam, Puerto Rico, and the US Virgin Islands are available for the dates of April 10, May 6, May 16, and June 3, 2020 through a NG website that requires government level access. These were examined to evaluate and analyze the activities directed by each state NG headquarters as part of COVID-19 response efforts. No other dates were available for analysis.Results:During the COVID-19 pandemic, the NG primarily provided security, tested for COVID-19, ran COVID-19 shelters, assisted foodbanks, delivered meals, provided transportation services, aided mortuaries, supported protective equipment warehouses, and deployed medical personnel to cover hospital shortages. They provided services to children, homeless persons, residents of skilled nursing facilities, and Native Americans living on tribal lands. Service members (SM) sewed masks, provided translation services, and cooked in prison kitchens. All state NGs participated in COVID-19 relief to varying degrees. Numerical data about the services provided such as quantity was rare but is included as available.Conclusion:The United States National Guard provided a wide variety of services through activation of its service men and women that impacted COVID-19 response throughout all states and territories. This elucidation of the uses of the National Guard should be considered during future governmental disaster preparedness planning efforts, and can be extrapolated to international military disaster relief.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Strategies to Operationalize Health Equity in Island Area Health Departments.

Breast, cervical, and colorectal cancer screening test use in the US territories of Guam, Puerto Rico, and the US Virgin Islands

BackgroundThe United States Preventive Services Task Force (USPSTF) recommends breast, cervical, and colorectal cancer screening among eligible adults, but information on screening use in the US territories is limited. MethodsTo estimate the proportion of adults up-to-date with breast, cervical, and colorectal cancer screening based on USPSTF recommendations, we analyzed Behavioral Risk Factor Surveillance System data from 2016, 2018, and 2020 for the 50 US states and DC (US) and US territories of Guam and Puerto Rico and from 2016 for the US Virgin Islands. Age-standardized weighted proportions for up-to-date cancer screening were examined overall and by select characteristics for each jurisdiction. ResultsOverall, 67.2% (95% CI: 60.6–73.3) of women aged 50–74 years in the US Virgin Islands, 74.8% (70.9–78.3) in Guam, 83.4% (81.7–84.9) in Puerto Rico, and 78.3% (77.9–78.6) in the US were up-to-date with breast cancer screening. For cervical cancer screening, 71.1% (67.6–74.3) of women aged 21–65 years in Guam, 81.3% (74.6–86.5) in the US Virgin Islands, 83.0% (81.7–84.3) in Puerto Rico, and 84.5% (84.3–84.8) in the US were up-to-date. For colorectal cancer screening, 45.2% (40.0–50.5) of adults aged 50–75 years in the US Virgin Islands, 47.3% (43.6–51.0) in Guam, 61.2% (59.5–62.8) in Puerto Rico, and 69.0% (68.7–69.3) in the US were up-to-date. Adults without health care coverage reported low test use for all three cancers in all jurisdictions. In most jurisdictions, test use was lower among adults with less than a high school degree and an annual household income of < $25,000. ConclusionCancer screening test use varied between the US territories, highlighting the importance of understanding and addressing territory-specific barriers. Test use was lower among groups without health care coverage and with lower income and education levels, suggesting the need for targeted evidence-based interventions.

Combining social network analysis and ethnography to better understand fishers’ organization and promote sustainable small-scale fisheries in St. Croix, US Virgin Islands

Given the importance of coral reef ecosystems to not only the health, livelihoods, and well-being of individuals and communities throughout the world, but also to global biodiversity, it is critical to improve our understanding of coral reef small scale fisheries (SSF) as social-ecological systems (SES). When examined using a SES approach, SSF operate within coupled-feedbacks with their surrounding marine ecosystems, and environmental outcomes depend upon interactions among a variety of social, ecological, and institutional factors. In a SES context, social network analysis (SNA) can illuminate how structure and process contribute to governance successes or failures among actors and natural resource systems. To address gaps in understanding what factors impact community cohesion, the flow of information, and potential for collective action in SSF, SNA was combined with rich ethnographic data focused on fishers in St. Croix, U.S. Virgin Islands. Results suggest that fishers in St. Croix are not organized into one cohesive group, and that demographic and fishing-related attributes influence group membership in non-uniform ways. These findings align with and build on recent work on SSF, but further demonstrate that the processes that influence the formation and maintenance of ties among fishers are complex and potentially site-specific. This makes it challenging to come to meaningful conclusions related to the potential for collective action based on SNA alone, but highlights the important role that in-depth ethnographic and other qualitative data can play.

Program Infrastructure the Key to Success: A Pilot Crosswalk Installation to Promote Walkability, Pedestrian Safety, and Physical Activity in the U.S. Virgin Islands.

While physical inactivity can contribute to chronic diseases, regular activity like walking can help prevent them. In 2010, one in three adults in the U.S. Virgin Islands (USVI) was physically inactive, higher than most U.S. states and territories. There are few walkable destinations and sidewalks along streets in the USVI. Since community- and street-scale design features can influence walking, we convened a 3-day walkability institute in the USVI to (1) learn about physical activity and best practices for design and (2) develop public health infrastructure that supports implementation. Island teams were formed to develop and implement a territory-wide action plan, focused on passing a Complete Streets policy, and demonstration projects on the islands of St. Croix, St. John, and St. Thomas to advance and pass this policy. An example of the demonstration projects and their significance is the completed one in St. Croix, which is the focus of this article. Island teams applied critical components of functioning program infrastructure as described in the Component Model of Infrastructure (CMI) such as engaged data, multilevel leadership, responsive plans and planning, and networked partnerships. We evaluated whether a crosswalk installation in St. Croix could alter driver and pedestrian behavior and create a safer environment for pedestrians. Observers recorded pedestrian crossing time, driver speed, and other behaviors before and after crosswalk installation. Pedestrians took significantly fewer average seconds to cross the street in the postdemonstration period (9.83) compared with predemonstration (13.4) (p = .03). Average car speed declined between the predemonstration (24.3) and long-term demonstration periods (p < .01) and from the postdemonstration (24.7) to the long-term demonstration period (18.2) (p < .01). A greater percentage of pedestrians used the crosswalk to cross the street between the postdemonstration (12.5%) and long-term demonstration periods (53.7%) (p < .01). The demonstration project in St. Croix shows that improvements to built environment infrastructure can increase safety for pedestrians, thus improving walkability in the USVI. We discuss the importance of CMI elements observed in the success of the St. Croix demonstration and its effectiveness in promoting a Complete Streets policy and the lack of these elements on St. John hindering progress there. Public health practitioners can apply the CMI to future physical activity promotion projects in the USVI and other settings as having functioning program infrastructure helps overcome challenges including natural disasters and a global pandemic and can achieve progress toward sustained policy and systems change.

Acoustic telemetry provides insights for improving conservation and management at a spawning aggregation site of the endangered Nassau grouper (Epinephelus striatus)

Nassau grouper (Epinephelus striatus, Serranidae) were one of the most important fishery species in the Caribbean, but are now listed as critically endangered. Population collapse in most places occurred primarily by fishers targeting their spawning aggregation sites, where thousands of fish gathered during full moon periods from December to April. Identifying management options for protecting this vulnerable period is crucial for their survival. In the US Virgin Islands, we tagged 24 Nassau grouper with acoustic transmitters at a fish spawning aggregation (FSA) site called the Grammanik Bank, a 1.5 km2, marine protected area (MPA) closed each year from February to April. We tracked their movements over a seven-year period and found that the small MPA protected Nassau grouper only 65% of time during the spawning season. Nassau grouper arrived at the FSA from January to May, with a peak in March, and made daily roundtrip migrations (1-25 km) from the FSA site. Females swam twice as far as males, while males were more sedentary and remained longer (22 d) at the FSA than females (9 d); behavioural characteristics that may cause differential bycatch mortality among sexes. We also found nearly half of all fish were temporary residents within 5 km of the FSA site for 2 to 6 months after the spawning season. This mismatch of MPA size and timing of closed season provided the impetus for developing new guidelines for protection. The large acoustic array allowed us to calculate spatially relevant areas useful for conservation including courtship arena (1.2 km2), staging area (4.7 km2) and primary migration pathways (9.6 km2) used by Nassau grouper during spawning season. To improve conservation goals of this endangered species, increasing the Grammanik Bank seasonal closure to five months and its size to 6.4 km2 would increase protection to &amp;gt;96%. These spatial and temporal changes to existing management regulations incorporate the best available data to improve conservation goals by reducing potential bycatch mortality, eliminating disturbance of spawning fish, and protecting critical spawning habitat for Nassau grouper. These guidelines may also be applied more broadly to other Nassau grouper FSA sites located on large insular or continental shelfs areas throughout the Caribbean.

Consumption of sugar-sweetened beverages and T2D diabetes in the Eastern Caribbean.

Sugar-sweetened beverages (SSB) are implicated in the increasing risk of diabetes in the Caribbean. Few studies have examined associations between SSB consumption and diabetes in the Caribbean. SSB was measured as teaspoon/d using questions from the National Cancer Institute Dietary Screener Questionnaire about intake of soda, juice and coffee/tea during the past month. Diabetes was measured using self-report, HbA1C and use of medication. Logistic regression was used to examine associations. Baseline data from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS), collected in Barbados, Puerto Rico, Trinidad and Tobago and US Virgin Islands, were used for analysis. Participants (n 1701) enrolled in the ECS. Thirty-six percentage of participants were unaware of their diabetes, 33% aware and 31% normoglycaemic. Total mean intake of added sugar from SSB was higher among persons 40-49 (9·4 tsp/d), men (9·2 tsp/d) and persons with low education (7·0 tsp/d). Participants who were unaware (7·4 tsp/d) or did not have diabetes (7·6 tsp/d) had higher mean SSB intake compared to those with known diabetes (5·6 tsp/d). In multivariate analysis, total added sugar from beverages was not significantly associated with diabetes status. Results by beverage type showed consumption of added sugar from soda was associated with greater odds of known (OR = 1·37, 95 % CI (1·03, 1·82)) and unknown diabetes (OR = 1·54, 95 % CI (1·12, 2·13)). Findings indicate the need for continued implementation and evaluation of policies and interventions to reduce SSB consumption in the Caribbean.

Zantray lan Ginen : Performing the Feminine and Haiti’s Sacred Spaces

Abstract: Here we come together as Caribbean artists committed to ecofeminist activism and the sacred sanctuaries that support life in this era of climate disaster . The multilateral conversation Zantray lan Ginen , which could be translated as “Afro-fertilized or Africa-fertilizing wombs,” is an exploration of the interconnectedness between Haiti and the Caribbean through Vodou, the kinships between women’s wombs and nature, and the sacredness that traverses those circles. At the crossroads of performance studies and environmentalism, this conversation brings together the creative ecologies and speech flows of four female artists: Haitian choreographer, artist and performer Linda Isabelle François Obas, interdisciplinary artist Oceana James from Saint Croix (US Virgin Islands), Cuban dancer-choreographer Yaima Santana Galindo, and me, Stéphanie Melyon-Reinette, a performer-choreographer from Guadeloupe. I met each of these other artists during my own artistic peregrinations in Cuba, Haiti, and Puerto Rico.

Sea urchin mass mortalities 40 y apart further threaten Caribbean coral reefs

In 1983 to 1984, a mass mortality event caused a Caribbean-wide, >95% population reduction of the echinoid grazer, Diadema antillarum. This led to blooms of algae contributing to the devastation of scleractinian coral populations. Since then, D. antillarum exhibited only limited and patchy population recovery in shallow water, and in 2022 was struck by a second mass mortality reported over many reef localities in the Caribbean. Half-a-century time-series analyses of populations of this sea urchin from St. John, US Virgin Islands, reveal that the 2022 event has reduced population densities by 98.00% compared to 2021, and by 99.96% compared to 1983. In 2021, coral cover throughout the Caribbean was approaching the lowest values recorded in modern times. However, prior to 2022, locations with small aggregations of D. antillarum produced grazing halos in which weedy corals were able to successfully recruit and become the dominant coral taxa. The 2022 mortality has eliminated these algal-free halos on St. John and perhaps many other regions, thereby increasing the risk that these reefs will further transition into coral-free communities.

Direct relief: a tradition of public service efficiency in global humanitarianism

Theoretical basis The case and discussion questions posed will allow the instructors the opportunity to introduce critical strategic concepts from strategic, nonprofit management and social enterprise literature. Specifically, (1) strategic transformation: countering drift and anticipating future trends and crises; (2) types of leadership: transactional versus transformational; (3) hybridity and mission drift; and (4) nonprofit funding models, the starvation cycle and the overhead myth. Research methodology Both primary and secondary sources have been used to prepare the case. The first two authors had the opportunity to interview Thomas Tighe, Direct Relief’s (DR) President and CEO in July of 2019. The interview lasted one hour and was transcribed by one of the authors and reviewed by the other two authors for accuracy. In addition, the authors conducted nonparticipant observations in DR’s headquarters in Santa Barbara (California). Given the longevity and media exposure of the organization, extensive internal and external archival data was also available for the analysis. Case overview/synopsis This real and undisguised case is based on DR, a +70-year-old humanitarian $1.2bn nonprofit organization headquartered in California (USA). From its headquarters in Santa Barbara, DR responds to emergencies and delivers medical support for vulnerable people affected by poverty, natural disasters and civil unrest in all 50 US states, six US territories including Puerto Rico and US Virgin Islands, and in more than 90 countries. The case presents Thomas Tighe, DR’s President and CEO, reflecting in late 2018 on the transformation and growth that the organization had experienced since he started his tenure in 2000. Specifically, he is considering the most effective way to allocate an unrestricted recent cash donation. Should DR spend that money on traditional fundraising, reducing its efficiency rate, or should DR take a long-term approach and use the funds to build long-term capabilities? In addition, the case outlines the history and evolution of DR over its more than 70 years of existence, the CEO’s background and motivations, as well as a detailed description of the organization’s revenue portfolio. Students will have an opportunity to learn about a unique nonprofit named among “the world’s most non-for-profit organizations” by Fast Company; DR was also included in the Charity Navigator’s list of the “10 Best Charities Everyone’s Heard of.” In addition, in January 2009, DR was designated as a Verified-Accredited Distributor by The National Association of Boards of Pharmacy, which placed it as the first nonprofit to receive this designation to deliver prescription medicines to all 50 US states. Throughout Tighe’s tenure, DR had been lauded for its fundraising efficiency. The unique distinction to DR’s efficiency is its tradition of adopting new technologies and modern business practices for humanitarian purposes. Students will learn how DR, under the leadership of Thomas Tighe, reinvented and reinforced the organization’s traditions to retain high levels of efficiency in the face of an ever-larger organizational scale, public scrutiny and demand for humanitarian support across the world. Students will witness many strategic and operational tenets that they may be more familiar with from the for-profit world. The case also will help students to understand the concept of hybrid organizations and different nonprofit funding models. Complexity academic level The case has been written to be used in graduate Nonprofit Leadership Management and Social Entrepreneurship courses. Given the scope and implications, the case could also be used on an upper-level strategy course. To maximize students’ learning, the case should be introduced halfway into the course after students have a solid understanding of what nonprofits are and how they operate. If students are not familiar with some of the concepts introduced in the analysis, the proposed readings will prepare them for a more fruitful discussion.

Acceptability of a Chikungunya Virus Vaccine, United States Virgin Islands.

Chikungunya virus, a mosquito-borne alphavirus, causes acute febrile illness with polyarthralgia. Groups at risk for severe disease include neonates, people with underlying medical conditions, and those aged ≥ 65 years. Several chikungunya vaccines are in late clinical development with licensure expected in the United States during 2023. We administered a questionnaire to randomly selected households in the U.S. Virgin Islands (USVI) to assess interest in a hypothetical chikungunya vaccine. Estimates were calibrated to age and sex of USVI population, and univariate and multivariable analyses were performed. Of 966 participants, 520 (adjusted 56%, 95% CI = 51-60%) were interested in receiving the vaccine. Of 446 participants not interested in vaccination, 203 (adjusted 47%, 95% CI = 41-52%) cited safety concerns as the reason. Educational efforts addressing vaccine safety concerns and risk factors for severe disease would likely improve vaccine acceptability and uptake among those most at risk.

Effects of arborescent octocoral assemblages on the understory benthic communities of shallow Caribbean reefs

Since about 2000, octocorals on the shallow reefs of St. John, US Virgin Islands, have increased in abundance to form dense stands analogous to terrestrial forests. In this study, the ecology of octocoral forests was explored by testing for an effect of their canopies on the light regime and benthic invertebrate community in the understory habitat. Octocoral forests at five sites (7–13 m depth) were quantified on a spatial scale of meters by the height and density of octocoral colonies. Their effects on the understory habitat were evaluated through measurements of downwelling light, benthic invertebrate community structure, and the photophysiology (i.e., induction time) of the common coral, Porites astreoides (Lamarck, 1816). Octocoral forests composed of dense (> 5 octocorals m−2) and tall (mean height of 42 cm) octocoral colonies created an understory habitat characterized by flashes of bright light (i.e., sunflecking). Within the understory habitat at two of three study sites, the community structure of benthic invertebrates was modified by the octocoral canopy, but it remained unaffected at a third site. A test for the effects of sunflecking on the induction time of P. astreoides found no difference between colonies in the understory versus the open reef habitat. These results do not support the notion that the physiological phenotype of autotrophs in the understory habitat is modified to exploit sunflecking. The analysis of the benthic invertebrates in the understory habitat suggests that octocoral forests can change the community structure of this group of organisms, relative to the open reef. The causes of this change are unclear, but its absence at the most sheltered study site suggests that water motion may be a contributing factor. The strong likelihood that octocoral forests mediate ecologically significant changes in the community structure of invertebrates within their understory habitat warrants further investigation.

Evaluating the Effectiveness of Point-of-Entry UV Treatment for Cistern Water among Households in the US Virgin Islands

UV water treatment can be a viable option for point-of-entry applications among households utilizing contaminated private water sources, including roof-harvested rainwater. However, limited data is available on UV system effectiveness and costs. Therefore, Love City Strong, an NGO in the US Virgin Islands, piloted a UV access program which included free UV systems with prefiltration along with installation and monthly household visits for up to 12 months, including water quality testing. In addition, a pilot study was conducted to evaluate the effectiveness of UV systems without prefiltration. Results from the UV access program demonstrated that E. coli was not detected in 95.1% of tap or spigot samples (n = 268). Among water quality parameters, household characteristics, and premise plumbing dynamics, no factor was significantly higher among samples with detections of E. coli or total coliforms. Among all samples from the pilot study of UV systems without prefiltration, no E. coli was detected (N = 24). Finally, there was a wide range of costs─first year and annual─when comparing different types and configurations of UV systems. Given these data, UV systems may be a viable option for generating potable water; however, clear purchasing and operational guidelines are important to reduce user error.

Healthcare and Social Organizations' Disaster Preparedness, Response, and Recovery Experience: Lessons Learned From Hurricanes Irma and Maria.

Healthcare and social organizations (HSOs) are first respondents after natural disasters. Hence, their preparedness and resilience are critical components for addressing future disasters. However, little is known about HSOs' experiences prior to, during, and after hurricanes. To describe preparedness, response, and recovery experiences from hurricanes Irma/ Maria among HSOs in Puerto Rico and the US Virgin Islands. Using a convenience sample, semi-structured interviews were conducted with 52 key-informants. Content analysis for common and recurring themes and patterns was performed by HSO type. Most HSOs (80.8%) had a preparedness plan and 55.8% responded providing emergency supplies. HSOs' human resources (61.2%) was the main recovery facilitator/ enabler, while 36.5% identified the lack of economic resources and the lack of an integrated emergency plan as the top barriers. The main lesson learned include understanding the need to make improvements to their emergency preparedness plans (56.3%), and to establish an integrated/ centralized plan between relevant parties. Lessons learned after hurricanes allowed HSOs to identify gaps and opportunities to become more resilient. Infrastructure capacity, human resources, communication systems, and economic support, as well as training, partnerships, and new policies should be defined, revised, and/ or integrated into the HSOs' preparedness plans to mitigate the impact of future disasters.